Our study has shown that decreasing the tibial slope >5° compared to pre-operative value has functionally favourable effect on the reconstructed ACL graft and outcome. It is known that increasing slope causes an anterior shift in tibial resting position that is accentuated under axial loads. This suggests that decreasing tibial slope may be protective in an ACL deficient knee. Hence by placing the tricortical graft posterior to midline in the opening wedge reduces the posterior tibial slope and thereby reduces the stress on the graft leading to better functional outcome.
Abstract:Articular cartilage flap tear of patella is a rare injury that occurs in children. Diagnosis is difficult both clinically and radiologically. Apart from knee swelling and retro-patellar tenderness, there is no other clinical finding. We report a case of 16 year old boy who suffered from patella cartilage flap tear without visible bony fragments. Mini-open reduction, microdrilling, sealing of margins with fibrin glue and double breasting of medial patellar retinaculum was performed. Early weight bearing was achieved together with a satisfactory range of knee motion. An awareness of cartilage flap tear, together with its characteristic clinical and radiological features and proper treatment is necessary to avoid misdiagnosis and treatment delay.
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