| Use of allografts after failed treatment of rupture of the anterior cruciate ligament. | |
| | |
MedLine Citation:
|
PMID: 8027109 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
A prospective study was done of the use of allogeneic tissue to reconstruct the anterior cruciate ligament in knees in which an intra-articular or an extra-articular operation had failed. Sixty-six consecutive patients (sixty-six knees) had such an operation with use of bone-patellar ligament-bone allografts; all but one returned for follow-up evaluation twenty-three to seventy-eight months (mean, forty-two months) after the operation. A total of 235 previous operations had been performed in these sixty-six knees, including eighty-one procedures for rupture of the anterior cruciate ligament. The results of the allograft procedure were evaluated with a subjective and objective system that rated twenty factors. The anterior-posterior displacement was substantially improved in most of the patients. According to data derived from arthrometric studies and pivot-shift tests of the fifty-seven patients who were so evaluated and in whom the condition was unilateral, 53 per cent (thirty) of the reconstructed ligaments were determined to be functional; 21 per cent (twelve ligaments), partially functional; and 26 per cent (fifteen ligaments), a failure. When we calculated the rate of failure by including ten failures that had occurred within two years after the operation with the fifteen that occurred in patients who had been followed for at least two years, the over-all rate of failure was 33 per cent (twenty-five of seventy-five operations). There was significant improvement in the subjective ratings of functional limitations and symptoms (p < 0.01) and in the over-all rating score (p < 0.0001). However, there was a significant difference between the scores of the patients in whom the surfaces of the articular cartilage had appeared normal at the index operation and those of the patients in whom there had been noteworthy fissuring and fragmentation or exposure of subchondral bone. After the program of rehabilitation, which included immediate motion of the knee, a range of motion of 0 to 135 degrees was restored in all but five knees, four of which lacked only 5 degrees of this extent of flexion or extension. The results demonstrate that bone-patellar ligament-bone allografts may be used when proper autogenous tissues are not available and that symptoms and abnormal displacement were reduced in most of our patients. |
| | |
Authors:
|
F R Noyes; S D Barber-Westin; C S Roberts |
Related Documents
:
|
7584189 - Which factors influence the progression of degenerative osteoarthritis after acl surgery? 17036779 - Autologous hamstring anterior cruciate ligament reconstruction in patients older than 40. 3365619 - A review of intra-articular knee injuries in racquet sports diagnosed by arthroscopy. 7552149 - Complications of extensor mechanism surgery for patellar malalignment. 18780999 - Accelerated rehabilitation after anterior cruciate ligament reconstruction. 8734879 - Primary repair for posterior cruciate ligament injuries. an eight-year followup of fift... 21288779 - Aes 2009 annual course: reoperation for medically refractory epilepsy. 19583539 - Canadian academic experience with metal-on-metal hip resurfacing. 7224919 - Removal of occipital arteriovenous malformations with sparing of visual fields. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Journal of bone and joint surgery. American volume Volume: 76 ISSN: 0021-9355 ISO Abbreviation: J Bone Joint Surg Am Publication Date: 1994 Jul |
Date Detail:
|
Created Date: 1994-08-11 Completed Date: 1994-08-11 Revised Date: 2010-10-25 |
Medline Journal Info:
|
Nlm Unique ID: 0014030 Medline TA: J Bone Joint Surg Am Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1019-31 Citation Subset: AIM; IM |
Affiliation:
|
Cincinnati Sportsmedicine and Orthopaedic Center, Ohio. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Activities of Daily Living Adolescent Adult Anterior Cruciate Ligament / injuries, surgery* Bone Transplantation / methods* Cartilage, Articular / pathology Exercise Therapy Female Humans Knee Injuries / rehabilitation Male Middle Aged Motion Therapy, Continuous Passive Patellar Ligament / transplantation* Postoperative Complications / etiology Range of Motion, Articular Reoperation Rupture Transplantation, Homologous |
| Comments/Corrections | |
Comment In:
|
J Bone Joint Surg Am. 1995 Aug;77(8):1290
[PMID:
7642675
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Flexor carpi radialis tendinitis. Part II: Results of operative treatment.
Next Document: Effects of gamma irradiation on the human immunodeficiency virus. A study in frozen human bone-patel...