PurposeThe purpose of the study was to identify the femoral tunnel orientation that consistently results in a tunnel length of more than 35 mm in anterior cruciate ligament reconstruction.Materials and MethodsComputed tomography (CT) scans were obtained from 30 patients who did not have any pathology in the distal femur. Virtual tunnels were marked on 3D (3-dimensional) reconstructed CT images after determining the orientation defined by sagittal inclination and axial angle. The length of a femoral tunnel in 64 different combinations of orientations (between 30° and 65° in 5° increments in two planes) was measured on 3D reconstructed images in both knees in 30 patients. Reliability of measurement was assessed with correlation coefficient for intra-observer and inter-observer measurements. A one-way analysis of variance (ANOVA) was used for statistical analysis.ResultsThe mean femoral tunnel length varied significantly with each 10° change in orientation in both planes (p<0.05, ANOVA). A femoral tunnel of more than 35 mm in length could be obtained only with a sagittal inclination of more than 50° and axial angle of 30°-45°. When the axial angle was kept constant, the tunnel length increased with the increase in sagittal inclination. Higher sagittal inclinations consistently resulted in longer tunnels (r>0.9) and reduced the incidence of posterior cortical breakage.ConclusionsA tunnel orientation with an axial angle between 30°-45° and a sagittal inclination of more than 50° can result in a tunnel length of more than 35 mm.
The practice of arthroscopy in India had started as early as 1978; and during the same year, the Indian chapter of the International Arthroscopy Association was drafted alongside other countries such as Australia and Brazil. The subspecialty of arthroscopy has been a boon to both; the orthopedic surgeon and the patient. The advent of arthroscopy has enabled the orthopedic surgeon to clearly visualize and delineate the extent of disease, with minimal invasion. Moreover, the patient is benefited with rapid recovery and an early return to activities. The present-day arthroscopic surgeries include diagnostic arthroscopy, ligament reconstruction, cartilage repair, and labral repairs and have undoubtedly evolved into a glamorous subspecialty in orthopedics. However, before the technological advancements, the technique of arthroscopy had modest origins. This review traverses through the history of arthroscopy with special emphasis on the advances of arthroscopy in India.
Background: Radiofrequency probes have been used extensively in various arthroscopic procedures. Measurable cartilage damage occurs after radiofrequency probe application. However, the histological changes of cartilage damage following radiofrequency chondroplasty have not been extensively studied.
Materials & Methods: Articular cartilage specimens were obtained from patients undergoing total knee replacement surgeries. Radiofrequency probes were applied at 1, 3 and 5 seconds and samples were sent to histopathology laboratory. The histological changes of cartilage damage were analyzed using the International Cartilage Repair Society (ICRS) assessment scale. Safranin O staining was done to assess the proteoglycan content.
Results: Histologically measurable articular cartilage damage occurs after radiofrequency probes
Conclusions: The time of application of radiofrequency probes should be optimized so as to minimize cartilage damage.
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