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ABSTRACT: PURPOSE: A positive glide is a common finding after ACL reconstructions, especially in women. The aim of this study was to prospectively evaluate the role of Cocker-Arnold's extra-articular procedure in reducing the incidence of a residual postoperative rotational knee laxity. METHODS: Sixty patients affected by an ACL injury with a +2 (clunk) or +3 (gross shift) pivot-shift test entered this prospective study; they were randomly assigned to group A (control group, hamstrings) or group B (study group, hamstrings plus Cocker-Arnold). Thirty-two patients entered group A and 28 group B. At follow-up, patients underwent clinical evaluation, KT-1000 arthrometer and Lysholm, Tegner, VAS and subjective and objective IKDC form. RESULTS: At a mean follow-up of 44.6 months, the same expert surgeon reviewed 55 patients (28 group A and 27 group B). The comparison of the results of the evaluation scales used and of the KT-1000 arthrometer did not show statistically significant differences (p > 0.05). Lachman test was negative (S/S) in all the patients of both groups (100 %). A residual positive pivot-shift (glide) was found in 16 patients (57.1 %) of group A and in five patients (18.6 %) of group B (p < 0.05). CONCLUSIONS: The extra-articular MacIntosh procedure modified by Cocker-Arnold in combination with ACL reconstruction significantly reduces the rotational instability of the knee.
International Orthopaedics 05/2012; · 2.03 Impact Factor
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ABSTRACT: PURPOSE: The purpose of this study was to evaluate the efficacy of platelet-rich plasma (PRP) in reducing femoral and tibial tunnel enlargement in patients operated on for anterior cruciate ligament reconstruction with hamstrings. METHODS: Forty male patients, in which both femoral and tibial 9-mm tunnels were performed because of the graft size, were enrolled in this prospective study. They were randomly assigned to group A (20 patients, PRP group) and group B (20 patients, control group). All patients were followed up at a median of 14.7 months (range 10-16 months), with a physical examination, the Tegner, Lysholm and objective IKDC scoring scales, and with the KT-1000 arthrometer. Moreover, they underwent a CT evaluation in order to assess the amount of tunnel enlargement. RESULTS: Femoral tunnel diameter increased from 9.0 ± 0.1 mm to 9.8 ± 0.3 mm in group A (p = 0.032) and from 9.0 ± 0.1 mm to 9.4 ± 0.5 mm in group B (p = 0.043). Tibial tunnel diameter increased from 9.0 ± 0.2 mm to 10.9 ± 0.2 mm in group A (p = 0.029) and from 9.1 ± 0.1 mm to 10.1 ± 0.4 mm in group B (p = 0.028). Physical examination as well as the evaluation scales used showed no differences between the two groups. CONCLUSIONS: The use of PRP does not seem to be effective in preventing tunnel enlargement. LEVEL OF EVIDENCE: Therapeutic study, Level II.
Knee Surgery Sports Traumatology Arthroscopy 04/2012; · 2.21 Impact Factor
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ABSTRACT: The aim of this study was to compare shoulder manipulation and arthroscopic arthrolysis with glenohumeral steroid injections in patients affected by idiopathic adhesive shoulder capsulitis.
In this prospective study we randomly assigned patients to enter group A (23 patients, shoulder manipulation and arthroscopic arthrolysis) and group B (21 patients, glenohumeral steroid injections). Patients were followed-up at three, six and 12 weeks, and at six and 12 months with the Constant and Murley, ASES, UCLA and SST evaluation scales. Moreover, passive forward flexion, abduction, and internal and external rotations were recorded.
Range of motion showed satisfactory results in both groups at final follow-up: in group A the mean ABD increased from 60° to 154°, ER from 20° to 40°, and FF from 75° to 174°; in group B, ABD raised from 76° to 145°, ER from 20° to 35°, and FF from 115° to 164°. All the evaluation scales performed increased significantly at final follow-up in both groups. However, while patients of group A had already reached significant improvement at the six-week follow-up (p <0.03), in group B this happened only at the 12 week follow-up (p <0.03).
Both types of treatment were effective in improving final range of motion; however, while patients of group A accomplished their goal by the six-week follow-up, in group B the same result was obtained at the 12-week follow-up.
International Orthopaedics 08/2011; 36(1):101-6. · 2.03 Impact Factor
