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Prevention of Medial Femoral Condyle Injury by Using a Slotted Cannula in Anterior Cruciate Ligament Reconstruction.

ABSTRACT: Anterior cruciate ligament injury is one of the most common ligament injuries of the knee in sports medicine. The treatment of choice is anterior cruciate ligament reconstruction, which requires an experienced surgeon. Complications may occur at every step of the procedure. The surgeon should be especially careful when performing the step of femoral tunnel creation. Damage to the medial femoral condyle (MFC) could occur; thus, the full functional outcome of the knee might be affected. There are many surgical techniques to avoid MFC injury. We propose a surgical technique that could reduce the risk of MFC injury. This technique uses a Fast-Fix slotted cannula (Smith & Nephew) as a protector. Because such equipment is available in all meniscus instrument sets, this surgical technique is a feasible and easy method to use during the femoral tunnel creation step.

SUBMITTER: Chuaychoosakoon C

PROVIDER: S-EPMC5794712 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Prevention of Medial Femoral Condyle Injury by Using a Slotted Cannula in Anterior Cruciate Ligament Reconstruction.

Chuaychoosakoon Chaiwat C Duangnumsawang Yada Y Apivatgaroon Adinun A

Arthroscopy techniques 20170918 5

Anterior cruciate ligament injury is one of the most common ligament injuries of the knee in sports medicine. The treatment of choice is anterior cruciate ligament reconstruction, which requires an experienced surgeon. Complications may occur at every step of the procedure. The surgeon should be especially careful when performing the step of femoral tunnel creation. Damage to the medial femoral condyle (MFC) could occur; thus, the full functional outcome of the knee might be affected. There are ...[more]

PMID: 29399447

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Project description:Anterior cruciate ligament injuries result in posttraumatic osteoarthritis in the medial compartment of the knee, even after surgical treatment. How the chondrocyte distribution within the articular cartilage changes early in this process is currently unknown. The study objective was to investigate the chondrocyte distribution within the medial femoral condyle after an anterior cruciate ligament transection in a preclinical model. Forty-two adolescent Yucatan minipigs were allocated to receive unilateral anterior cruciate ligament surgery (n = 36) or no surgery (n = 6). Central coronal sections of the medial femoral condyle were obtained at 1- and 4 weeks after surgery, and the chondrocyte distribution was measured via whole slide imaging and a cell counting batch processing tool utilized in ImageJ. Ki-67 immunohistochemistry was performed to identify proliferating cells. Empty lacunae, karyolysis, karyorrhexis, and pyknosis were used to identify areas of irreversible cell injury. The mean area of irreversible cell injury was 0% in the intact controls, 13.4% (95% confidence interval: 6.4, 20.3) at 1-week post-injury and 19.3% (9.7, 28.9) at 4 weeks post-injury (p < .015). These areas occurred closest to the femoral intra-articular notch. The remaining areas containing viable chondrocytes had Ki-67-positive cells (p < .02) and increased cell density in the middle (p < .03) and deep zones (p = .001). For the entire section, the total chondrocyte number did not change significantly post-operatively; however, the density of cells in the peripheral regions of the medial femoral condyle increased significantly at 1- and 4 weeks post-injury relative to the intact control groups (p = .032 and .004, respectively). These data demonstrate a peripheral shift in the viable chondrocyte population of the medial femoral condyle after anterior cruciate ligament injury and further suggest that chondrocytes with the capacity to proliferate are not confined to one particular cartilage layer.

Dataset Information

Prevention of Medial Femoral Condyle Injury by Using a Slotted Cannula in Anterior Cruciate Ligament Reconstruction.

Publications

Prevention of Medial Femoral Condyle Injury by Using a Slotted Cannula in Anterior Cruciate Ligament Reconstruction.

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