Background and Objectives: Anterior cruciate ligament (ACL) tears are common injuries in the athletic population, and accordingly, ACL reconstruction (ACLR) is among the most common orthopedic surgical procedures performed in sports medicine. This study aims to compare the semitendinosus/gracilis (ST/G) and ACL hamstring grafts fixed using adjustable cortical suspension in both the femur and tibia (MAI) ACLR techniques. We aimed to compare the results of single-leg hop tests (SLHT) applied in different directions and limb symmetry indices (LSI) in athletes with a 6-month post-operative ACLR history. Materials and Methods: A retrospective cohort of 39 athletes from various sports branches who underwent MAI (n = 16) and ST/G (n = 23) ACLR techniques by the same surgeon were evaluated. The knee strength of the participants on the operated and non-operated sides was evaluated with five different SLHTs. The SLHT included the single hop for distance (SH), triple hop for distance (TH), crossover triple hop for distance (CH), medial side triple hop for distance (MSTH), and medial rotation (90°) hop for distance (MRH). Results: There was a significant improvement in the mean Lysholm, Tegner, and IKDC scores in the post-operative leg for both techniques (p < 0.05) compared to the pre-operative levels. When there was a difference between the SH of the operative and the non-operative legs in the ST/G technique (p < 0.05), there was no significant difference in the other hop distance for both ST/G and MAI (p > 0.05). There was no difference between the techniques regarding the LSI scores. Conclusions: The fact that our research revealed similar LSI rates of the SLHTs applied in different directions in the ST/G and MAI techniques assumes that the MAI technique can be an ACLR technique which can be functionally used in athletes.
This study compared the clinical outcomes of patients treated with described “modified all-inside” anterior cruciate ligament reconstruction (ACLR) technique with those of patients treated with suspensory femoral fixation and a bioabsorbable tibial interference screw with the ACLR technique. From 2017 to 2019, 98 patients who underwent ACLR surgery by two surgeons using either of the techniques were included in this study. Patients in group 1 were treated with the “modified all-inside” ACLR technique. In this technique, only the semitendinosus tendon was harvested as a four-strand graft and fixed to the tibia and femur with suspensory buttons. Patients in group 2 were treated with suspensory femoral fixation and a bioabsorbable tibial interference screw ACL reconstruction technique. Patients' functional outcomes were evaluated by the Lysholm score, Tegner activity scale, and International Knee Documentation Committee (IKDC) subjective score. Postoperative knee stability of the patients was evaluated using the Lachman test and the pivot-shift test. The mean ages of the patients were 31.1 (16–55) and 28.7 (18–48) years in groups 1 and 2, respectively. The average follow-up durations were 26 (20–30) and 25.9 (22–30) months for both groups. There was no significant difference between the preoperative and postoperative Lysholm's score, Tegner's activity score, and IKDC subjective score in groups 1 and 2. There were no major complications or reruptures in either group. ACLR incorporating the “modified all-inside” ACLR technique obtained significant clinical outcomes compared to ACLR with a suspensory femoral fixation and a bioabsorbable tibial interference screw.
IntroductionImplants used in orthopedic surgery can be colonized by bacteria that form biofilm layers complicating treatment. We aimed to determine titanium implants' antibacterial and biofilm-degrading properties when coated with sodium borate (NaB) and calcium borate (CaB) minerals.
MethodsWe analyzed twenty-four different implants. Three implants were not coated, three were coated with only a carrier polymer (alginate), and eighteen were coated with either CaB or NaB at different concentrations. The implants were incubated with Staphylococcus aureus, and then the bacterial colonies were enumerated.
ResultsThe highest microbial load was observed on the implant coated with alginate (1000 colony-forming units [CFU]/mL). The implant without coating contained a microbial load of 420 CFU/mL. The microbial loads of the implants coated with 0.75 mg/mL CaB or 0.25, 0.5, and 0.75 mg/mL NaB (100, 200, 0, and 0 CFU/mL, respectively) were lower than that of the implant without coating. No biofilm formation was observed on implant surfaces coated with 0.5 mg/mL NaB, 0.75 mg/mL NaB, or 0.75 mg/mL CaB; biofilm formation was observed on the implant without coating and alginate-coated implants surfaces.
ConclusionAt high concentrations, borate minerals (NaB and CaB) have a potent antibacterial effect on colonization and biofilm formation on the implant surface. These elements may be used in implant coating in the future because of their potential antibacterial effects.
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