Anterior cruciate ligament reconstruction with hamstring tendons has no deleterious effect on hip extension strength

Background: Hamstring tendons are secondary hip extensors. Their harvest for graft in anterior cruciate ligament (ACL) reconstruction may create deleterious effect on hip extension strength. This is of particular importance in sports that need powerful hip extension force like climbing and sprinting. Due to scarcity of a comprehensive study in this area, we designed this prospective study to evaluate hip extension strength following ACL reconstruction using different types of grafts. Methods: Fifty eight patients were enrolled in this prospective non-randomized case control study to compare isokinetic hip extension strength following ACL reconstruction with different graft types. Twenty patients in group A (both Semitendinosus and Gracilis tendons autograft (ST-G)), 14 patients in group B (Tibialis Posterior tendon allograft (Allograft)), 12 patients in group C (bone-patellar tendon-bone autograft (BPTB)) and 12 patients in group D (only semitendinosus autograft (ST)) were studied. Hip extension strength was tested post-operatively at three- and six-month periods using a Biodex isokinetic testing machine at a speed of 30 degree per second in operated (cases) and non-operated (controls) limbs. Results: There was a significant increase in hip extension force between three and six month intervals in all four groups and in both operated (case) and non-operated (control) limbs (P<0.05, 95 CI). However, there was more increase in case limbs in comparison to control limbs. There was no significant difference in hip extension strength among all four groups (both in case and control limbs) in the third- and the sixth-month post-operative tests. Conclusion: Graft type had no effect on hip extension strength following ACL reconstruction, and the harvest of one or both hamstrings had no deleterious effect on hip extension force. COPYRIGHT 2019 © BY THE ARCHIVES OF BONE AND JOINT SURGERY

Preoperative pulmonary function tests in different surgical approaches of adolescent idiopathic scoliosis

&quot;nBackground: Scoliosis is one of the most common spinal deformities with subsequent decrease in pulmonary function. The effects of surgical correction on the pulmonary function of patients with adolescent idiopathic scoliosis are controversial. The purpose of the present study was to compare the postoperative pulmonary function changes in different surgical approaches chosen for its correction.&quot;n &quot;nMethods: Sixty-five patients with adolescent idiopathic scoliosis who had undergone corrective spinal surgery in Shafa Yahyaian Hospital since 1997 to 2007 and had documented preoperative pulmonary function test report, included in our study. The patients had documented preoperative pulmonary function tests and were divided into three groups based on their surgical approach. The first group was comprised of 25 patients who had undergone posterior spinal fusion (PSF), the second group included 29 patients who had anterior and posterior spinal fusion (ASF+PSF), and the third group consisted of 10 patients who had posterior spinal fusion and thoracoplasty (PSF+ thoracoplasty). The preoperative and the final follow-up values of absolute and percent predicted forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were compared and their relations with the undertaken surgical approach were evaluated.&quot;n &quot;nResults: There were no significant correlations between the surgical approaches and changes in the pulmonary function tests (P&amp;gt;0.05). FVC and FEV1 values were similar to preoperative values in all groups after a minimum follow-up of two years.&quot;n &quot;nConclusion: There were no significant differences between different surgical approaches for adolescent idiopathic scoliosis regarding the pulmonary function test results after at least two years of follow-up