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- Liden, M, et al.
(författare)
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A histological and ultrastructural evaluation of the patellar tendon 10 years after reharvesting its central third
- 2008
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 36:4, s. 781-788
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Tidskriftsartikel (refereegranskat)abstract
- This study was undertaken to evaluate the histologic and ultrastructural characteristics of the patellar tendon 10 years after reharvesting its central third. Hypothesis In the long term, after its central third is reharvested, the patellar tendon does not regain a normal histological and ultrastructural appearance. Study Design Case-control study; Level of evidence, 3. Methods Twelve consecutive patients (4 women, 8 men) who underwent anterior cruciate ligament revision surgery using reharvested ipsilateral patellar tendon autografts were included in the study. Percutaneous biopsy samples were obtained from the central and lateral parts of the patellar tendon under ultrasonographic guidance at a median of 116 months (range, 102–127 months) after the revision procedure. Eleven biopsy specimens from asymptomatic patellar tendons obtained from open anterior cruciate ligament reconstructions served as controls. The histologic characteristics and the presence of glycosaminoglycans were assessed using a light microscope, and the ultrastructure was assessed using a transmission electron microscope. Results The histological evaluation revealed deterioration in fiber structure, increased cellularity, and increased vascularity in both the central and peripheral parts of the reharvested patellar tendon specimens compared with normal tendon specimens. No difference in the amount of glycosaminoglycans was seen in specimens from either part of the reharvested patellar tendons and the control specimens. The ultrastructural evaluation revealed that all the control specimens had a normal morphologic appearance and a compact extracellular matrix with regularly oriented collagen fibrils. Furthermore, in the control specimens, the fibril diameter was heterogeneous, with all fibril size classes present. Specimens from the central and the lateral part of the reharvested tendon displayed pathological cell appearance and a more heterogeneous extracellular matrix. The lateral specimens from the reharvested tendons also displayed all fibril size classes but with a more homogeneous distribution. In the central specimens, the largest fibril size class was absent. Conclusion Ten years after its central third was reharvested for anterior cruciate ligament revision surgery, the patellar tendon had not normalized in terms of its histological and ultrastructural appearance.
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- Sernert, Ninni, 1954, et al.
(författare)
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Knee-laxity measurements examined by a left-hand- and a right-hand-dominant physiotherapist, in patients with anterior cruciate ligament injuries and healthy controls
- 2007
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - 0942-2056.
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to analyse and compare KT-1000 knee laxity as examined by a left-hand- and a right-hand-dominant physiotherapist in a group of patients with an anterior cruciate ligament (ACL) injury and a group of patients, 2 years after ACL reconstruction. The other aim was to measure and analyse knee laxity in a group of persons without any known knee problems. A cross-sectional examination of two groups of patients pre-operatively and post-operatively after ACL reconstruction and examination of healthy controls on two different occasions was performed. Fifty-three patients who were scheduled for ACL reconstruction and 39 patients who attended a 2-year follow-up examination were included in the study. In the ACL-deficient group, 32 patients had a right-sided ACL injury and 21 patients a left-sided ACL injury. The corresponding figures in the post-operative group were 21 patients with a right-sided ACL injury and 18 patients with a left-sided ACL injury. Twenty-eight healthy persons without any known knee problems served as controls. One left-hand- and one right-hand-dominant experienced physiotherapist performed all the examinations. To be able to evaluate the intra and inter-reliability of the examiners the controls were examined at two occasions. The left-hand-dominant physiotherapist measured significantly higher absolute laxity values in the left knee, both injured and non-injured ones, compared with the right-hand-dominant physiotherapist. This was found irrespectively of whether the patients belonged to the ACL deficient or the post-operative group. In the healthy control group, the right-hand-dominant physiotherapist measured significantly higher knee-laxity values in the right knee compared with the left-hand-dominant physiotherapist. Correspondingly, the left-hand-dominant physiotherapist measured significantly higher knee laxity values in the left knee. We conclude that KT-1000 arthrometer laxity measurements can be affected by the hand dominance of the examiner. This might affect the reliability of KT-1000 arthrometer measurements. Level of evidence is II.
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