Comparative Determination of the Mechanical Strength of a Transplant from a Tendon of a Semitendinosus Muscle for Plastic Surgery of the Anterior Cruciate Ligament Prepared in Various Ways (Experimental Study)

According to modern literature, a sufficient number of studies have been carried out to determine the mechanical strength of transplants from the tendon of the semitendinous and gracilis muscles, the autologous ligament of the patella, the broad fascia, peroneus longus tendon, each of which has unique characteristics, but at present, transplants prepared by original (new) methods are understudied.In the period from November 5 to December 17,2018 we conducted an experimental study to determine the mechanical strength of a transplant from a tendon of a semitendinosus muscle taken from cadaveric material. The transplants were prepared by original and well-known (Graft-Link technique) methods.The experimental study was approved by the Ethics committee of Irkutsk Scientific Center of Surgery and Traumatology. The material for the study was prepared on the basis of the Irkutsk Regional Bureau of Forensic Medical Examination.After sampling the cadaveric material being studied, the main stages of the experimental study were carried out at the materials resistance department of the Irkutsk State Technical University. Studies of the mechanical properties of the transplant were carried out on a Shimadzu testing machine registered in the State Register of Measuring Instruments and approved for use in the Russian Federation.As a result of the study, we obtained the following data. The mechanical strength of the graft obtained from the tendon of the semitendinosus muscle in an original way is on average 607.8 ± 101.2 N/mm. The mechanical strength of the graft obtained from the tendon of the semitendinosus muscle in a traditional manner (Graft-Link technique) is on average 351.8 ± 133.0 N/ mm

EXPERIENCE IN THE TREATMENT OF THE FALSE JOINT OF THE DIAPHYSIS OF THE RADIAL BONE COMBINED WITH A MAJOR DEFECT IN THE ULNAR DIAPHYSIS (CASE FROM PRACTICE)

This article presents the experience of surgical treatment of rare pathology of the upper limb – pseudoarthrosis of the middle third of the diaphysis of the radius, defect pseudoarthrosis of the upper and middle third of the ulnar diaphysis. The definition and compilation of an accurate model and treatment tactics are critical to restoring the anatomy and function of the injured upper limb. The rarity of this case was the size of the ulna defect, which was up to 4.0 cm, the scarring and cicatricial changes in the soft tissues and muscles of the right forearm, due to the severity of the injury and the multitude of surgical interventions on the right forearm. The chosen treatment tactics consisted of several successive stages: resection of the zone of false joint of the right radial bone, combined transosseous osteosynthesis of the right radius bone, resection of the false elbow joint of the right ulna with replacement of the defect with autograft from the lower third of the fibula, combined strained osteosynthesis and transosseous osteosynthesis by external fixation apparatus with rod configuration of the right ulna. The results of surgical treatment of false joints depend on the determination of the correct indications for a certain type of surgical intervention and the competent implementation of the planned treatment plan. The chosen treatment tactics allowed us to successfully restore the anatomy and function of the damaged segment, thus rehabilitating the patient

Single and Double Bundle Arthroscopic Reconstruction of Anterior Cruciate Ligament (Review of Literature)

Researches performed in the past 20 years show the necessity of the restoration of anatomic position of anterior cruciate ligament as the main stabilizing structure of the joint in combination with the restoration of other injured elements and correction of deformities, which affect the outcomes of the treatment.Complexity of the restoration of anatomic position of torn anterior cruciate ligament is caused by its wide area of contact in combination with relatively small sectional area through the joint cavity. More detailed study of topographic anatomy of anterior cruciate ligament allowed the researchers to explain this phenomenon, which pushed them closer to the solution of the problem.Systemic anatomy of anterior cruciate ligament include two bundles - anteromedial bundle and posterolateral bundle. Double bundle plasty of anterior cruciate ligament restored anatomy to its nearly normal condition, but single bundle plasty is used much more often because of its simpler technique. However, the researchers still cannot reach a consensus in the choosing of single or double beam plasty at the restoration of anterior cruciate ligament

Comparative analysis of the results of the anterior cruciate ligament reconstruction using an autograft preparation by known and new methods

Background. To date, the problem of choosing the optimal graft for anterior cruciate ligament (ACL) reconstruction and the methods for its formation is one of the main trends in the surgical treatment of patients with anterior knee joint instability.The aim. To compare the results of the anterior cruciate ligament reconstruction using the known method and the new proposed method for autograft formation.Materials and methods. The results of treatment of ACL injury in 44 patients were assessed. In the main group (19 patients), an original technique of ACL reconstruction from 1/2 of the width of m. peroneus longus tendon was used. In the control group (25 patients), ACL reconstruction was performed using a graft from the m. semitendinosus tendon prepared by the Lubowitz method.Results. The mean difference in the circumference of the distal third of the hip in the main group was 1.57 ± 1.162 cm and was statistically significantly better than in the control group, where the mean difference in the hip circumference was 4.74 ± 1.7207 cm.The range of motion of the knee joint in the main group 3 months after the surgery was 128.42 ± 9.287°, and in the control group mean flection was 109.6 ± 9.120°.The functional results in the main group were assessed by the Lisholm scale and were statistically significantly better than the results in the control group. The functional results by the AOFAS (American Orthopedic Foot & Ankle Society) scale in the main group were 100 points before the surgery and at all terms after the surgery: this indicates that the use of 1/2 of the width of m. peroneus longus tendon does not cause the its functional impairement.Conclusion. Anterior cruciate ligament plasty with use of 1/2 of the width of m. peroneus longus tendon prepared by the proposed method showed statistically significantly better results compared to the preparation of autograft from semitendinous muscle tendon using known method