Preoperative evaluation of spinoglenoid ganglion cyst with MRI, EMG and isokinetic muscle test – Does size matter?

Ho Yun Joung, Joo Han Oh, Sae Hoon Kim, Dae Ha Kim, Seok Hoon Yang, Sung Min Rhee, Hyeon Jang Jeong, Kyung Soon Jeong, Shang Mi Shim, Chintan Desai
2016 Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology  
improvement of the initial reconstruction to preserve the medial meniscus at the time of the first surgery. Conclusion: High BMI, early graft failure, severe medial meniscus injury is a cause of inferior outcome of the clinical results of re-ACL reconstruction using ART-BTB technique. http://dx. Background: Tears of anterior cruciate ligament (ACL) were considered a rare injury in children and adolescents, but a number of recent studies suggest that their incidence is increasing. Treatment
more » ... ing. Treatment strategies for ACL tears in patients with open physes have evolved, however, there are still no clear management guidelines. It used to be thought that surgery should be delayed until skeletal maturity to prevent violation of the physes and consequent disturbance of growth. It is now generally accepted that operative intervention gives a better functional outcome. The purpose of this study is to compare the outcomes of physeal sparing ACL reconstruction and delayed reconstruction in patients with open physes. Material & Method: We evaluated 12 patients (7 men and 5 women), who were treated for ACL tears either by physeal sparing reconstruction (PS group, n¼6) or delayed reconstruction (D group, n¼6) between 2009 and 2014. The mean age at the time of injury was 12.1 years for the PS group and 13.7 years for the D group. The physeal sparing reconstruction we performed was as follows. An incision was made to the distal portion of lateral femur and epiphyseal line was identified. Thereafter, the femoral double round tunnels were created distal to epiphyseal line by using outside-in guide. The tibial double round sockets were drilled by using retrodrill system. The results of both groups were compared postoperative Tegner activity score, Lysholm score, International Knee Documentation Committee (IKDC) grade and physical examination findings (Lachman test, Pivot shift test). Statistical analysis was performed using SPSS software (IBM-SPSS, New York, USA). A nominal p value of <0.05 was considered to indicate statistical significance. Results: The average postoperative Tegner and Lysholm score was 6.8, 98.7 in PS group and 7.0, 99.0 in D group, respectively. There was no significant difference in both score (p¼0.87, p¼0.75). One patient in both groups was IKDC grade B, but all other patients were grade A. The results of the Lachman test were all normal, and the results of the pivot shift test were glide for one patient in both group and normal for all other patients. At the time of operation, two patients in D group were noted meniscus tear, which were not found at the time of injury. No patient had a re-rupture or a discrepancy in the length of the lower extremities measured clinically. Discussion: ACL reconstruction in patients with open physes is a controversial topic. This is the first report of the physeal sparing and anatomic double bundle reconstruction for skeletally immature patients. Our ACL reconstruction technique yields satisfactory clinical results. In this study, two patients were noted meniscus tear in D group, therefore conservative treatment of ACL injuries often leads to poor and unacceptable results. Conclusion: This case series indicates good results of double bundle ACL reconstruction with use of physeal sparing technique in patients with open physes. http://dx.
doi:10.1016/j.asmart.2016.07.180 fatcat:26vmgjd7gngfjhpxawo3cu6ewa