scholarly journals Application of suture bridge technique in the treatment of acute patellar ligament injury

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0052
Author(s):  
Ming Zhou ◽  
Wen Zou
Keyword(s):  
Knee Joint ◽  
Knee Extensor ◽  
Postoperative Recovery ◽  
Acute Injury ◽  
Patellar Ligament ◽  
Ligament Injury ◽  
Suture Bridge ◽  
Ligament Rupture ◽  
Bone Fragments ◽  
Suture Bridge Technique

Introduction: The patellar ligament, as a knee extensor, plays an important role in knee movement. Patellar ligament tear completely divided into acute and chronic, acute general mishandling lead to fracture again, chronic patellar ligament rupture, need surgery to restore again and device, the integrity of the patellar ligament rupture time more than 2 weeks or more, it’s easy to have a different degree of scar healing, a normal tendinous portion elasticity and tension were significantly decreased, eventually leading to knee disorders. If scar tissue is removed by surgery and sutured again, the required strength of the patellar ligament cannot be provided, resulting in long postoperative recovery time, knee joint dysfunction, muscle atrophy, joint degeneration and other problems. Hypotheses: To explore the method and clinical effect of suture bridge technique in the treatment of acute patellar ligament injury. Methods: From January 2016 to October 2018, 13 patients with Acute injury of patellar ligament insertion were treated with suture bridge technique.Among them, there were 11 males and 2 females, aged from 17 to 35 years, with an average age of 26.3 years.The average time from injury to operation was from 3 to 5 days, with an average day of 3.5 days.Thirteen patients all suffered from closed injury at the inferior end of patella. Among them, 8 had no fracture at the inferior end of patella, 5 had bone fragments and none had avulsion at the tibial end.Thirteen patients all suffered from closed injury at the inferior end of patella. Among them, 8 had no fracture at the inferior end of patella, 5 had bone fragments and none had avulsion at the tibial end.Suture bridge technique was used in 13 cases.Postoperative knee function was assessed by Lysholm score Results: All patients were followed up for 7 to 15 months, with an average of 11.2 months.All incisions healed well, and there were no complications such as infection and re-rupture of patellar ligament.At 6-12 weeks after operation, the range of motion of 13 patients reached the level of uninjured side.According to Lysholm scoring criteria, knee joint function was excellent in 9 cases and good in 4 cases Conclusion: Suture bridge technique in the treatment of acute patellar ligament injury has the characteristics of firm fixation, fewer complications, quick recovery and avoidance of second operation.

scholarly journals Preliminary clinical outcomes of the double-row anchor suture-bridge technique for the fixation of tibial intercondylar eminence fractures in adults: a 12-months minimal follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yupeng Chu ◽  
Ting Hu ◽  
Mangmang Chen ◽  
Chendi Jiang ◽  
Zhuqi Wu ◽  
...  
Keyword(s):  
Knee Joint ◽  
Clinical Outcomes ◽  
Double Row ◽  
Suture Bridge ◽  
Post Surgery ◽  
Intercondylar Eminence ◽  
The Mean ◽  
Suture Bridge Technique ◽  
Anchor Suture

Abstract Background Tibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. However, the incidence of such fractures is increasing in adults, concurrent with an increase in sports injuries and traffic accidents. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in adults; and evaluates its preliminary clinical outcomes. Methods A retrospective evaluation of adult patients with tibial intercondylar eminence fractures treated at our institution from June 2016 to June 2018 was conducted. Seven such patients, treated with the anchor suture-bridge technique, were included. All patients were assessed for knee joint range of motion (ROM), Lysholm knee score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form score, Tegner activity score pre-surgery, and the healing of the fracture at 3, 6 and 12 months minimal post-surgery follow-up. Results Patients were followed for a mean of 12.43 months (range 9-15 months). By the final follow-up, all fractures had fully healed. The mean Lysholm score improved from 27.86 (range, 2 to 54) pre-surgery to 88.14 (range, 81 to 100) 3 months post-surgery (p < 0.05). Similarly, the mean IKDC score improved from 48.86 (range, 43 to 55) to 84.29 (range, 75 to 90) (P < 0.05); and the mean Tegner activity score improved from 1.71 (range, 0 to 4) to 3.29 (range, 2 to 4) (p < 0.05). Furthermore, knee joint ROM, Lysholm scores, IKDC scores, and Tegner activity scores displayed excellent outcomes at the 6 and 12 months minimal follow-up. Conclusion The arthroscopic anchor suture-bridge technique is a valid and secure method for achieving effective fixation of tibial intercondylar eminence fractures in adults.

scholarly journals Surgical Repair Using Suture Bridge Technique for Triceps Tendon Avulsion

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ryogo Furuhata ◽  
Yusaku Kamata ◽  
Aki Kono ◽  
Taichi Nishimura ◽  
Shinya Otani ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Limited Range ◽  
Fracture Site ◽  
Suture Anchors ◽  
Suture Bridge ◽  
Limited Range Of Motion ◽  
Bone Fragments ◽  
Triceps Tendon ◽  
Tendon Avulsion ◽  
Suture Bridge Technique

Triceps tendon avulsion is a rarely occurring tendinous injury. Various surgical procedures, such as repair using sutures through the transosseous tunnel or suture anchors, have been reported for treating triceps tendon avulsion. However, standard surgical treatment has not yet been established. Here, we present a case of triceps tendon avulsion treated using the suture bridge technique. A 58-year-old man who fell on his left elbow from standing height presented to our hospital. Plain radiography revealed an avulsion fracture of the left olecranon process, suggesting triceps tendon avulsion. We performed surgical repair of the avulsed bone fragments and ruptured triceps tendon. We inserted suture anchors into the ulna, proximal to the fracture site, and passed the sutures through the full thickness of the triceps. Subsequently, fracture fragments were reduced and fixed by pulling them together with the triceps. We inserted knotless anchors into the ulna distal to the fracture site and fixed the avulsed bone fragments and triceps tendon using the suture bridge technique. The patient recovered well in five months and reported no elbow pain or limited range of motion. This suture bridge technique is advantageous as it prevents iatrogenic fracture and knot irritation, and it would be indicated in cases with poor bone quality or thin skin soft tissue of the olecranon.

scholarly journals Lateral femoral notch sign and posterolateral tibial plateau fractures and their associated injuries in the setting of an anterior cruciate ligament rupture

2021 ◽  
Author(s):  
Alexander Korthaus ◽  
Malte Warncke ◽  
Geert Pagenstert ◽  
Matthias Krause ◽  
Karl-Heinz Frosch ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Ligament Injury ◽  
Ligament Rupture ◽  
Impression Fracture ◽  
Anterior Cruciate ◽  
Lateral Femoral Notch ◽  
Femoral Notch

Abstract Introduction ACL injury is one of the most common injuries of the knee joint in sports. As accompanying osseous injuries of the ACL rupture a femoral impression the so-called lateral femoral notch sign and a posterolateral fracture of the tibial plateau are described. However, frequency, concomitant ligament injuries and when and how to treat these combined injuries are not clear. There is still a lack of understanding with which ligamentous concomitant injuries besides the anterior cruciate ligament injury these bony injuries are associated. Materials and methods One hundred fifteen MRI scans with proven anterior cruciate ligament rupture performed at our center were retrospectively evaluated for the presence of a meniscus, collateral ligament injury, a femoral impression, or a posterolateral impression fracture. Femoral impressions were described according to their local appearance and posterolateral tibial plateau fractures were described using the classification of Menzdorf et al. Results In 29 cases a significant impression in the lateral femoral condyle was detected. There was a significantly increased number of lateral meniscal (41.4% vs. 18.6% p = 0.023) and medial ligament (41.4% vs. 22.1%; p = 0.040) injuries in the group with a lateral femoral notch sign. 104 patients showed a posterolateral bone bruise or fracture of the tibial plateau. Seven of these required an intervention according to Menzdorf et al. In the group of anterior cruciate ligament injuries with posterolateral tibial plateau fracture significantly more lateral meniscus injuries were seen (p = 0.039). Conclusion In the preoperative planning of ACL rupture accompanied with a positive femoral notch sign, attention should be paid to possible medial collateral ligament and lateral meniscus injuries. As these are more likely to occur together. A posterolateral impression fracture of the tibial plateau is associated with an increased likelihood of the presence of a lateral meniscal injury. This must be considered in surgical therapy and planning and may be the indication for necessary early surgical treatment.

scholarly journals Use of the modified Insall Salvati method for determination of vertical patellar position in dogs with and without cranial cruciate ligament rupture considering the morphology of the cranio-proximal tibia

2012 ◽  
Vol 81 (4) ◽  
pp. 403-407 ◽  
Author(s):  
Dávid Kňazovický ◽  
Valent Ledecký ◽  
Marián Hluchý ◽  
Marek Ďurej
Keyword(s):  
Cruciate Ligament ◽  
Patellar Ligament ◽  
Insertion Point ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Healthy Dogs ◽  
Cranial Cruciate Ligament Rupture

The aim of this study was to evaluate if the modified Insall Salvati (IS) method can be applied for the canine patient despite differences of proximal tibial morphology, and if such potential differences are also seen in dogs with cranial cruciate ligament rupture. Insall Salvati method is a simple and convenient method for determination of the vertical position of patella, by dividing the length of patella by length of the patellar ligament. The influence of the variable proximal tibial morphology on the modified (IS) index was measured and the value of modified IS index in healthy dogs (n = 25) was compared with dogs with cranial cruciate ligament rupture (n = 26). Medio-lateral radiographs of 102 stifles were evaluated. Patellar ligament length (PLL), patellar length (PL), modified IS ratio and the height of insertion point of patellar ligament on tibial tuberosity were measured. Data of the IS ratio were compared with the value of the height of the insertion point with no significant difference (P = 0.36). There was no significant difference (P = 0.07) in the PLL:PL ratio between dogs affected or unaffected with cranial cruciate ligament rupture. Based on the results of this study we can conclude that the morphology of the cranio-proximal tibia and the height of insertion point of the patellar ligament do not have an influence on the value of the modified IS index both in healthy dogs and in dogs with cranial cruciate ligament rupture.

scholarly journals Efficacy of Achilles Suture Bridge Technique for Insertional Achilles Tendinosis in an Obese and Athletic Patient

2016 ◽  
Vol 63 (3.4) ◽  
pp. 310-314 ◽  
Author(s):  
Kazuaki Mineta ◽  
Naoto Suzue ◽  
Tetsuya Matsuura ◽  
Koichi Sairyo
Keyword(s):  
Achilles Tendinosis ◽  
Suture Bridge ◽  
Suture Bridge Technique

Deconstructing the Anterior Cruciate Ligament: What We Know and Do Not Know About Function, Material Properties, and Injury Mechanics

2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Scott G. McLean ◽  
Kaitlyn F. Mallett ◽  
Ellen M. Arruda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Mechanical Response ◽  
Cruciate Ligament ◽  
Complex Structure ◽  
Acute Injury ◽  
Research Attention ◽  
Increased Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury is a common and potentially catastrophic knee joint injury, afflicting a large number of males and particularly females annually. Apart from the obvious acute injury events, it also presents with significant long-term morbidities, in which osteoarthritis (OA) is a frequent and debilitative outcome. With these facts in mind, a vast amount of research has been undertaken over the past five decades geared toward characterizing the structural and mechanical behaviors of the native ACL tissue under various external load applications. While these efforts have afforded important insights, both in terms of understanding treating and rehabilitating ACL injuries; injury rates, their well-established sex-based disparity, and long-term sequelae have endured. In reviewing the expanse of literature conducted to date in this area, this paper identifies important knowledge gaps that contribute directly to this long-standing clinical dilemma. In particular, the following limitations remain. First, minimal data exist that accurately describe native ACL mechanics under the extreme loading rates synonymous with actual injury. Second, current ACL mechanical data are typically derived from isolated and oversimplified strain estimates that fail to adequately capture the true 3D mechanical response of this anatomically complex structure. Third, graft tissues commonly chosen to reconstruct the ruptured ACL are mechanically suboptimal, being overdesigned for stiffness compared to the native tissue. The net result is an increased risk of rerupture and a modified and potentially hazardous habitual joint contact profile. These major limitations appear to warrant explicit research attention moving forward in order to successfully maintain/restore optimal knee joint function and long-term life quality in a large number of otherwise healthy individuals.

Knee Joint Response to Compressive Loading and Ligament Injury

1999 ◽  
Author(s):  
Jordan Lee ◽  
Frank Fronczak
Keyword(s):  
Knee Joint ◽  
Cruciate Ligament ◽  
Compressive Loading ◽  
Degree Of Freedom ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Acl Injuries ◽  
Measuring Machine ◽  
Anterior Cruciate ◽  
Six Degree Of Freedom

Abstract The knee joint is a six degree-of-freedom joint which has a complex response to loading. The joint has a characteristic behavior for particular ligament injuries such as anterior cruciate ligament failure. The response of the joint to a combination of compressive loading and secondary loadings was examined in this study. The secondary loadings were: an anterior force, a valgus moment, an internal torque, or an external torque. A goat model was used with 17 specimens testing different ligament injuries in vitro, specifically stretched or severed anterior cruciate ligaments (ACL) and lateral collateral ligaments (LCL). The femur was held fixed and the tibia loaded in a specially designed apparatus, allowing complete six degree-of-freedom joint motion. The motion of the tibia with respect to the femur was recorded using a coordinate measuring machine. The knee joint demonstrated sensitivity to ACL injuries but not to LCL injuries for the loadings examined. The response to ACL injuries was more highly dependant on the compressive load than the secondary loadings for all tests.

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