Posterior cruciate ligament and posterolateral corner reconstruction in patient with multiple ligament injury of the knee: a case report

The treatment of posterolateral corner (PLC) knee injuries has always been a challenging topic due to the low healing capacity of PLC injuries. Authors performed posterior cruciate ligament reconstruction using semitendinosus tendon graft and reconstruction procedure of PLC using free gracilis tendon graft with LaPrade technique in a patient with multiple ligament injury of the knee. A 36-years-old male patient complained of pain on his right knee. On physical examination, the posterior drawer test, dial test, and varus stress test were positive. Magnetic resonance imaging (MRI) on right knee showed that the posterior cruciate ligament (PCL), lateral collateral ligament, and popliteofibular ligament were injured but the popliteus tendon was still intact. A semitendinosus tendon was harvested from the ipsilateral pes anserinus region for posterior cruciate ligament reconstruction. Posterolateral corner reconstruction was done by grafting two gracilis tendons from ipsilateral and contralateral sides using LaPrade technique. The semitendinosus tendon graft had been used for PCL reconstruction in some cases besides the hamstring tendon graft and provides a clinically evident reduction in symptoms and restores satisfactory stability. The LaPrade technique for PLC reconstruction was one of the earliest descriptions of a surgical option to recreate the anatomy of the three main static stabilizers of the PLC.  We reported a reconstructive procedure for PCL and PLC injury of the knee by using semitendinosus and gracilis tendon graft with LaPrade technique

Potential use of glucosamine, chondroitine, chitosan and phytoestrogen for patients with osteoarthritis

The burden of musculoskeletal disease has increased significantly to become the second leading cause of YLD (years of life with disability). Osteoarthritis (OA) therapy that is often given is ibuprofen (NSAID) often give side effects. Therefore, it is necessary to conduct a literature review to explore evidence of how much potential these materials have for treating OA. The literature review was conducted on four databases, e.g., Pubmed, Scopus, Science direct, Clinical Key. We used several keywords to find each topic of discussion. Topic 1, benefits of glucosamine chondroitine; topic 2, benefits of chitosan; topic 3, benefits of phytoestrogens. Data from included studies were then extracted. Obtained data were analyzed using descriptive statistical methods. Glucosamine-chondroitin had a significant effect in reducing pain, reducing inflammation, reducing the rate of joint space narrowing and helping to improve joint function in OA patients with long-term use. Furthermore, the potential of chitosan can help bone remodeling, reduce pain, and inflammation. Besides, phytoestrogens also have the potential to increase bone mineral density, reducing the rate of bone turnover and reduce the occurrence of obesity through its anti-cholesterol effects. The complexity of the mechanism of action given, ranging from preventing the biggest risk factor, namely obesity; treating the main causes such as inflammation and cartilage damage; and also to treating the symptoms such as joint pain and stiffness. In the future, it is necessary to conduct clinical trials study using the ingredients glucosamine, chondroitin, chitosan and phytoestrogens to treat patients with OA