Objective To study the method and cl inical results of arthroscopic double-bundle posterior cruciate l igament (PCL) reconstruction using achilles tendon allograft. Methods From September 2005 to September 2006, 17 patients with PCL injuries of grade III received arthroscopic double-bundle PCL reconstruction using achilles tendon allograft. There were 12 males and 5 females with an average age of 31.7 years (range, 19-48 years), including 10 cases of left PCL injuries and 7 cases of right PCL injuries. Injury was caused by sports in 6 cases and traffic accident in 11 cases. The average time from injury to surgery was 16 days (range, 7-30 days). The preoperative knee flexion was (121.8 ± 4.1)°. The posterior drawer test was positive and the varus angulation test was negative in all 17 patients. Lysholm score was 50.8 ± 6.1 and Tegner score was 1.3 ± 0.7. The side-to-side difference was (10.5 ± 1.6) mm by KT-1000 arthrometer. Results The hospital ization were (13.6 ± 2.4) days. The operation time was (67.8 ± 9.4) minutes. The time was (5.4 ± 1.2) days when the body temperature was higher than 37.4 ℃ after operation. All incisions healed by first intention. No compl ication occurred. All 17 patients were followed up 25 months on average (range, 18-30 months). The knee flexion was (116.9 ± 3.1)° at the final follow-up, showing no significant difference when compared with that of preoperation (P gt; 0.05). The posterior drawer test and the varus angulation test were negative in all 17 patients. Lysholm score and Tegner score were 91.6 ± 3.2 and 6.0 ± 0.7, respectively, and the side-to-side difference was (2.7 ± 1.7) mm, showing significant differences when compared with those of preoperation (P lt; 0.05).Conclusion Achilles tendon allograft is fit for PCL reconstruction. Arthroscopic double-bundle posterior cruciate l igament reconstruction using achilles tendon allograft can reconstruct both anterolateral and posteromedial bundles of the PCL. The knee joint function can be restored effectively. The short-term outcome has been proved, but the long-term outcome needs more observations
Objective To explore the cl inical effectiveness of debridement in treatment of Pes anserinus bursitis under arthroscopy by comparing the curative effect of three therapies: local block therapy, open operation and debridement under arthroscopy. Methods From January 2000 to January 2007, 90 cases of unilateral Pes anserinus bursitis were treated with debridement under arthroscopy (group A, n=30), local block therapy (group B, n=30) and open operation (group C, n=30),respectively. The group A included 18 males and 12 females, aged (40.0 ± 2.5) years old; the locations were left knee in 16 cases and right knee in 14 cases; 10 cases had injury history, 7 cases had tired history and 13 cases had no obvious inducement; the course of disease was (24.0 ± 3.2) weeks. The group B included 17 males and 13 females, aged (37.0 ± 2.5) years old; the locations were left knee in 15 cases and right knee in 15 cases; 10 cases had injury history, 8 cases had tired history and 12 cases had no obvious inducement; the course of disease was (26.3 ± 3.5) weeks. The group C included 16 males and 14 females, aged (39.8 ± 2.2) years old; the locations were left knee in 18 cases and right knee in 12 cases; 8 cases had injury history, 10 cases had tired history and 12 cases had no obvious inducement; the course of disease was (25.0 ± 3.9) weeks. There was no statistically significant difference in the general data among three groups (P gt; 0.05). Results All patients were followed up 15 months on average (12-24 months). In group C, the inflammatory reation occurred at wound in 9 cases (30%) at 3-10 days after operation and was cured after symptomatic management; other incision healed by first intention; and showing statistically significant differences when compared with other 2 groups (P lt; 0.05). In group C, joint swell ing occurred at 1 week after operation in 1 case, l imitation of joint motion in 2 cases at 10-12 weeks after operation and was recovered after symptomatic management. In group B, 21 cases (70%) had a recurrence at 6-12 months after operation, all patients of other 2 groups had no recurrence; showing statistically significant differences between group B and groups A, C (P lt; 0.05). At last follow-up, the pain remain rates were 3.3% (group A), 0 (group B) and 33.3% (group C), and the compl ication incidence rates were 3.3%, 26.7% and 70.0%, respectively; all showing statistically significant differences among three groups (P lt; 0.05). At last follow-up, there were statistically significant differences in the visual analogue scale (VAS) score, the HSS score, and range of motion (ROM) between preoperation and postoperation in group A (P lt; 0.05); there was no statistically significant difference in the VAS score, HSS score and ROM between preoperation and postoperation in group B (P gt; 0.05); the ROM of postoperation in group C was smaller than that of preoperation (P lt; 0.05). There were statistically significant differences in the VAS score and HSS score between group A and groups B, C (P lt; 0.05), and in ROM among three groups after operation (P lt; 0.05). Conclusion The treatment of Pes anserinus bursitis with debridement under arthroscopy has advantages of easy-to-do, less compl ication, low relapse rate and good functional rehabil itation.