Combined arthroscopic resection with repair of joint capsule using tendon flap of medical head of gastrocnemius for treating popliteal cyst

Purpose Several studies have recently found an association between acetabular labral tears and the early onset of osteoarthritis. For this reason, treatment of labral tears in young and active patients is crucial for hip preservation. We retrospective reviewed 300 cases for hip acetabular labral tears that treated with hip arthroscopy surgery. The clinical results and image evaluation results were analyzed. Method From Mar 2007 to May 2013 ,300 consecutive cases of hip acetabular labral tears were treated with hip arthroscopy surgery ,we divided there cases to 4 groups:1.Acute hip trauma. 2.Acetabular labral tears combined with Femoroacetabular impingement (FAI) 3.Acetabular labral tears combined with bonderary hip dysplasia.(CE angle 20°-25°) 4.Acetabular labral tears combined with severe hip dysplasia(CE angle <20°). All the patients were evaluated by clinical examination, X ray film, MRI. The mean follow up time was 3.6 years (2-5 years). Results For Acute hip trauma cases,36 patients were included. We performed hip arthroscopic surgery that including loose body removal and debridement of the labral tears. Two of the patients were treated with internal fixation of the posterior wall fracture of acetabular rim and labral repair under arthroscopic surgery. The mean modified harris score(MOS) was improved significantly from 56.2±4.8 pre-operatively to 95.6±3.7 post-operatively. (P<0.01). For FAI cases, 234 patients were included. All the patients were treated with acetabular rim trimming and osteoplasty of femoral neck and head junction under arthroscopy surgery.168 patients were treated with labral repair and 66 patients were treated with labral tears debridement. The mean MOS of the labral repair group was significantly improved from 68.3±3.4 pre-operatively to 97.4±2.8 post-operatively. (P<0.01).The mean MOS of the labral debridement group was significantly improved from 65.3±4.8 pre-operatively to and 95.4±4.1. (P<0.01). There was no significant different between the two groups.(P>0.05). For acetabular labral tears combined with bonderary hip dysplasia cases(CE angle 20°-25°).25 patients were included. All the patients were treated with labral repair under arthroscopy surgery. The mean MOS was improved significantly from70.1±2.8 pre-operatively to 98.3±4.3 post-operatively. (P<0.01). For acetabular labral tears combined with seveve hip dysplasia cases(CE angle <20°), 5 patients were included. All the patients were treated with labral repair under arthroscopy surgery. The mean MOS was not significantly improved from 65.2±4.5 pre-operatively to 67.3±5.1 post-operatively. One 59 years old patients complicated with hip subluxation at 6 months after operation and revised by hip arthroplasty. The postoperative results were poor (P>0.05). Conclusion Hip arthroscopy surgery seems to be an effective method for treating hip acetabular labral tears cases for patients not combined with severe hip dysplasia. The mid-term results showed good improvement of the clinical evaluation no matter labral repair of debridement but not for the severe hip dysplasia cases. A morphologic and quantitative comparison of mechanoreceptors in the tibial remnants of the ruptured human anterior cruciate ligament Lin Sha, Jinzhong Zhao Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine 2 Department of Arthroscopic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Abstract Background: Reconstruction of the ruptured anterior cruciate ligament (ACL) does not always result in the expected successful outcome. A satisfactory outcome may depend not only on the tightness or strength of the graft but also on the quality of proprioceptive restoration. Mechanoreceptors of the ACL are supposed to play a considerable role in the proprioceptive feedback system of the knee. Our purpose was to observe the condition and number of the surviving mechanoreceptors in the tibial remnant of the ruptured ACL in human knees. Method: From April 2009 to January 2014, sixty patients with existing free tibial remnants who had undergone arthroscopic ACL reconstruction were divided into 4 groups according to the time of injury. As control, six normal ACL specimens were taken. Specimens were obained from ACL tibial remnant and stained by immunohistochemical staining method. The type, size, and quantity of mechanoreceptors were observed under light microscope. Result: A total of 92 Ruffini-like corpuscles, 9 Pacini-like corpuscles, 5 unclassified neural endings and free nerve endings were identified via immunohistochemical staining. There were no statistical differences in the number of mechanoreceptors observed in the five groups (P=0.238). Some degenerative changes were observed in Group IV. Conclusion: The results suggest that the residual mechanoreceptors in the ruptured ACL exhibit long-term survival and show no obvious signs of withering within 1 year. If the remnant is preserved during ACL reconstruction, it may provide a source of graft reinnervation and proprioceptive nerve fiber ingrowth, which may contribute to improved proprioceptive function and a successful clinical outcome.Background: Reconstruction of the ruptured anterior cruciate ligament (ACL) does not always result in the expected successful outcome. A satisfactory outcome may depend not only on the tightness or strength of the graft but also on the quality of proprioceptive restoration. Mechanoreceptors of the ACL are supposed to play a considerable role in the proprioceptive feedback system of the knee. Our purpose was to observe the condition and number of the surviving mechanoreceptors in the tibial remnant of the ruptured ACL in human knees. Method: From April 2009 to January 2014, sixty patients with existing free tibial remnants who had undergone arthroscopic ACL reconstruction were divided into 4 groups according to the time of injury. As control, six normal ACL specimens were taken. Specimens were obained from ACL tibial remnant and stained by immunohistochemical staining method. The type, size, and quantity of mechanoreceptors were observed under light microscope. Result: A total of 92 Ruffini-like corpuscles, 9 Pacini-like corpuscles, 5 unclassified neural endings and free nerve endings were identified via immunohistochemical staining. There were no statistical differences in the number of mechanoreceptors observed in the five groups (P=0.238). Some degenerative changes were observed in Group IV. Conclusion: The results suggest that the residual mechanoreceptors in the ruptured ACL exhibit long-term survival and show no obvious signs of withering within 1 year. If the remnant is preserved during ACL reconstruction, it may provide a source of graft reinnervation and proprioceptive nerve fiber ingrowth, which may contribute to improved proprioceptive function and a successful clinical outcome. The Study of Interleukin-8 on Anterior Cruciate ligament Reconstruction with Remnant Preservation BeomKooLee,TaewonKim,Kyung-Ok Kim (1)Gil hospital Gachon university (2)Gil hospital Gachon Medical Research Institute Objectives Preservation of Remnant Attachment Improves Graft Healing in a Rabbit Model of Anterior Cruciate Ligament Reconstruction. The aim of this study was to investigate the role of interleukin 8 between remnant preserved versus conventional anterior cruciate ligament reconstruction especially during the early stage Methods 40 cases of ACL reconstruction was studied. Group I was 20 cases of remnant preserving and group II was 20 cases of ACL reconstruction without remnant preservation we collect the joint fluid from the patients every 3 months and Interleukin-8 was measured using Multiplex assay. Stability is measured by stress radiogram using Telos device at 30 flexion at postoperative 3,6 12 Month. ACL signal intensity on MRI after mean period 13 months(10~18months) of operation was measured. Results At 3 Months , IL 8 was elevated in 55 % in group I & 25% in group II anterior displacement measured by stress radiogram using Telos was 0.46mm ± 0.19 in groupI and 3.39mm ± 0.28 in group II at post-operative 3 Month , 1.15mm ± 0.25 in group I, 2.96mm ± 0.28 in group II at post-operative 6 month, 2.96mm ± 0.28 in group I , 2.87mm ± 0.34 in group II at post-operative 12 month, mechanical stability was better in group I than group II with statistical significance There was increased signal on F-up MRI in group II than group I with statistical significance Conclusions The remnant preservation ACL reconstruction may be beneficial for ligamentization of the graft tendon during the first 3 months and for mechanical stability.