Followup of femoral condyle osteochondral allografting demonstrated durable improvement in pain and function, with graft survivorship of 82% at 10 years.

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Objectives-To determine the histological patterns of posterior cruciate ligament (PCL) degeneration during aging and in relation to changes in articular cartilage and anterior cruciate ligament (ACL) across the entire adult age spectrum.Methods-Human knee joints (n=120 from 65 donors) were processed within 72 hours postmortem. Articular cartilage surfaces were graded macroscopically. Each PCL was histologically evaluated for inflammation, mucinous changes, chondroid metaplasia, cystic changes and orientation of collagen fibers. Severity of PCL degeneration was classified as normal, mild, moderate or severe. PCL scores were compared to ACL and cartilage scores from the same knees.Results-All knees had intact PCL. Histologically, 6% were normal, 76% showed mild, 12% moderate and 9% severe degeneration. Fiber disorientation was the most prevalent and severe change. Histological grades of PCL and ACL correlated but significantly fewer PCL than ACL showed severe changes. There was weaker correlation between aging and total histological PCL scores (R=0.26) compared to aging and ACL scores (R=0.42). ACL scores correlated with cartilage scores (R=0.54) while PCL scores increased with severity of OA from grades 0 to III but not between OA grades III to IV (R=0.32). In knees with ruptured ACL, the PCL scores correlated with cartilage scores of the lateral compartment.Conclusions-PCL histopathological changes are less severe than in the ACL. PCL degeneration was associated with ACL and cartilage damage. The lack of correlation with age indicates independent pathways for PCL versus ACL degeneration.

Background: Offset and leg length (LL) restoration are critical for the achievement of a stable, well-functioning hip following total hip arthroplasty (THA). Several techniques are described in the literature, including a hip calibration gauge. We question whether meticulous preoperative planning of a specific surgical technique in combination with the utilisation of a calibration gauge can provide an accurate offset and LL restoration. Methods: Retrospective review of 101 unilateral THAs via a posterior approach by a single surgeon. Preoperative radiographic LL and offset were radiographically calculated. Intraoperatively prior to hip dislocation a calibration gauge was used to measure LL and offset with a pin inserted into the iliac crest acting as a static referencing point. All had pelvis x-ray performed 6 weeks postoperatively. A literature review was conducted to establish average postoperative LL/offset values for statistical comparison. Results: The average absolute postoperative leg-length discrepancy (LLD) was 2.51 mm compared to preoperatively 3.54 mm ( p = 0.018). A total of 93.1% and 100% had LLD of ⩽5 mm and ⩽10 mm, respectively. The mean postoperative offset difference was 2.39 mm. The investigated LLD and offset results were comparable with literature data of studies utilising an intraoperative measuring device. LLD was significantly decreased when compared to a free-hand technique (LLD 4.42 mm, p < 0.001). Conclusion: The technique utilising preoperative templating, intraoperative offset verification together with the use of hip calibration gauge yielded accurate LLD and offset restoration as in the literature. Precise offset restoration, which often is a neglected issue, can lead to better abductor vector restoration, hip function and less pain.