Quantitative evaluation of revascularization at bone tunnels and grafts with contrast-enhanced magnetic resonance angiography after anterior cruciate ligament reconstruction

2016 ◽  
Vol 40 (7) ◽  
pp. 1531-1536 ◽  
Author(s):  
Hitoshi Kanamura ◽  
Yuji Arai ◽  
Kunio Hara ◽  
Takeshi Takahashi ◽  
Kazuya Ikoma ◽  
...  
Joints ◽  
2018 ◽  
Vol 06 (03) ◽  
pp. 188-203 ◽  
Author(s):  
Anna Palazzolo ◽  
Federica Rosso ◽  
Davide Bonasia ◽  
Francesco Saccia ◽  
Roberto Rossi ◽  
...  

AbstractAnterior cruciate ligament reconstruction (ACL-R) is a common surgical procedure, with good outcome in 75 to 97% of the cases. However, different complications have been described including infection, hemarthrosis, deep vein thrombosis (DVT), and pulmonary embolism (PE) with a rate ranging from 1 to 15%. There are few case reports in the literature describing rare complications after ACL-R and they can be divided into: (1) complications related to the fixation device (rupture, migration); (2) fractures (tibial or femoral side); (3) infections due to uncommon bacteria, mycobacterium, and mycosis; (4) rare vascular injuries; (5) nerve injuries; and (6) other rare complications. In case of fixation device rupture or migration, device removal can be easy but the diagnosis may be challenging. Patellar fracture after ACL-R may be related to harvesting and it is not uncommon. Conversely, femoral or tibial fractures are most frequently due to bone weakness related to bone tunnels. Some rare infections related to uncommon bacteria or mycosis are also described with potentially devastating joint damage. Popliteal artery injuries are uncommon in ACL-R but minor vessels damages are described with possible severe consequences for patients. Injuries to the infrapatellar branch of the saphenous nerve are not uncommon in ACL-R. However, there are few case reports also describing injuries to the saphenous nerve, the common peroneal nerve and the sciatic nerve. The aim of this paper is to review the literature describing uncommon complications after ACL-R, giving some more information about diagnosis and treatment.


2020 ◽  
Vol 26 (2) ◽  
pp. 128-138
Author(s):  
V. V. Slastinin ◽  
N. V. Yarygin ◽  
M. V. Parshikov ◽  
A. M. Fain ◽  
M. V. Sychevskiy ◽  
...  

The study purpose — to evaluate the clinical results and the condition of bone tunnels after anterior cruciate ligament reconstruction with a semitendinosus tendon graft using cortical fixation and corrugated sutures.Materials and Methods. The results anterior cruciate ligament reconstruction with a semitendinosus tendon autograft were analyzed in 57 patients aged 18 to 53 years. The patients of the first group (n = 27) underwent anterior cruciate ligament reconstruction with a semitendinosus tendon graft using cortical fixation on the femur and tibia in combination with corrugated sutures at the proximal and distal ends of the graft. The patients of the second group (n = 30) underwent anterior cruciate ligament reconstruction in a similar way, but without the use of corrugated sutures. Clinical results were assessed using the Lysholm and IKDC scales. The degree of bone tunnels widening was evaluated by CT data in 6 months after the surgery.Results. In the first group, the degree of postoperative bone tunnels widening was significantly lower (for the femoral tunnel by 18% and tibial — by 17%) compared with the second group (for the femoral tunnel by 30% and tibial — by 31%). Scores by the IKDC 2000 and Lysholm scales were higher in the corrugated sutured group. Although, the treatment outcome was interpreted as equally good for both groups. The time for graft preparation was on average 6 minutes longer in the first group. This slightly increased the duration of the surgery.Conclusion. The anterior cruciate ligament reconstruction with a semitendinosus tendon graft using cortical fixation on the femur and tibia in combination with corrugated sutures ensured the tight contact of the tendon inside the bone tunnels without additional implants and reduced the degree of tunnels widening. This is important for a possible re-grafting. The proposed method does not significantly affect the clinical outcomes.


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