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Knee Research

 

bulletInterobserver Variability of the Insall-Salvati Ratio.  This clinical investigation, published in the journal Orthopedics in 2003, revealed that a traditional technique used in the measurement of knee X-ray films was more reliable than a newer technique in analyzing the position of the patella (knee cap) in relation to the rest of the knee joint.

 

bulletQuadriceps Tendon Impingement from Femoral Interference Screw: A Case Report.  This clinical report, published in the journal, Arthroscopy, in 2003, shares with the world a hitherto unreported complication of anterior cruciate ligament (ACL) reconstruction. A patient came to see Dr. Ilahi for persistent pain and stiffness following ACL reconstruction done elsewhere. The patient's original surgeon was at a loss to explain this. Dr. Ilahi's investigation revealed that a screw-type device used to secure the ligament reconstruction was protruding from the femur (thigh bone) and rubbing on the tendon of the quadriceps muscle, just above the knee. The resulting pain was hampering rehabilitation, especially the ability of the patient to regain knee joint flexion. In addition, the protruding screw was actually leading to slow tearing of the tendon. After Dr. Ilahi surgically removed the offending hardware and addressed the partially torn quadriceps tendon by an outpatient arthroscopic procedure, full flexion of the knee joint was quickly restored, and the patient's pain alleviated.

 

bulletArthroscopic Findings in Knees Undergoing Proximal Tibial  Osteotomy.  A proximal tibial osteotomy is a joint re-alignment procedure used to treat certain cases of knee arthritis where the joint has worn out primarily in one region and is associated with an abnormal alignment of the lower extremity.  By correcting the alignment of the lower extremity, the forces across the joint are redistributed so the worn out area sees less force and the more healthy part of the joint carries more force.  This can result in many years of relief from arthritic pain yet allow unrestricted activities, unlike knee replacement procedures, which often require restriction from strenuous activities lest the artificial components wear out prematurely.  The osteotomy is open surgery and does not involve the knee joint itself.  In this clinical investigation, published in early 2008 in the Journal of Knee Surgery, patients undergoing the osteotomy also had arthroscopic evaluation of the knee joint and were found to have a rather high and previously unknown incidence of correctable knee problems in addition to arthritis.  Correcting these  arthroscopically at the same time as the osteotomy may lead to better outcomes than performing the osteotomy alone.  Performing minimally invasive knee arthroscopy at the time of the open osteotomy surgery was not found in this investigation to lead to any increased complications.

 

bulletIntra-tunnel Fixation vs. Extra-tunnel Fixation of Hamstring ACL Reconstruction. A Meta-analysis.  This investigation, published in 2009 in the Journal of Knee Surgery, analyzed the results of numerous previous publications of ACL reconstruction results using hamstring tendons to replace a torn ACL. Specifically, two types of techniques for securing the hamstring tendon grafts were compared to each other as well as to a more traditional approach of using the patellar tendon to reconstruct the torn ACL. The traditional approach works well, but has greater associated discomfort, making rehabilitation more painful. Fortunately, the results of this investigation confirmed that the less painful hamstring reconstruction can give comparable results, given adequate fixation.

 

bulletFemoral Tunnel Length: Accessory Anteromedial Portal Drilling Versus Transtibial Drilling.  Recent investigations have suggested that better functional results can be obtained by reconstructing a torn anterior cruciate ligament (ACL) by creating a bone tunnel in the femur (thigh bone) through a small skin incision (portal) rather than the more traditional method of drilling through a tunnel in the tibia (main shin bone). However, several investigations using human cadavers raised concern that tunnels created through a portal could be too short to allow the healing of the graft that is placed to function as a new ACL. This investigation, published in early 2012 in the journal, Arthroscopy, was the first to definitively show that femoral tunnels created through an accessory anteromedial portal had a very low risk of creating femoral tunnels so short as to cause worry about healing of the reconstruction graft.

 

Copyright 2003 Texas Arthroscopy & Sports Medicine Institute, LLC
Last modified: 06/05/12