By K. P. Schulitz, H. Krahl, W. H. Stein (auth.), Professor Dr. Klaus-Peter Schulitz, Professor Dr. Hartmut Krahl, Dr. Wolfgang Hans Stein (eds.)
Different perspectives concerning the biomechanics of the knee joint and overdue re building of ligamentous accidents underline the hindrances impeding the institution of more often than not appropriate ideas for the deal with ment of such lesions. As overdue as June 1976, HUGHSTON emphasised within the magazine of Bone and Joint surgical procedure that during spite of good anatomic reports, significant uncertainty nonetheless prevails in knee joint surgical procedure. Even the signifi cance of the anterior drawer signal for ruptures of the anterior cru ciate ligament is interpreted fairly diversely, as illustrated in a comparability of HUGHSTON, GIRGIS, TORG, and SCHIECK, who provide various evaluations in regards to the indication concerning the age of the sufferer or attainable past joint harm in addition to in regards to the diagnosis for untreated knee joints. The query nonetheless continues to be as to how usually an intra-articular ligamentous substitute could be performed as well as extra-articular recommendations (0 'DONOGHUE, SLOCUM, NICHOLAS, HUGHSTON). finally the query of man-made ligament substitute has to be clarified. After easy examine has good complex, medical ex perience needs to be mentioned. Statements in regards to the healing worth of various systems dependent completely on wisdom of the literature stay difficult. therefore a workshop was once held on the college of Heidelberg within the Orthopedic medical institution (Head: Prof. Dr. H. COTTA) in June 1977, with the purpose of bringing jointly representatives of different top faculties in a around desk dialogue to touch upon nonetheless unsolved ques tions.
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Additional info for Late Reconstructions of Injured Ligaments of the Knee
WEBER: As far as I have understood, vascularization is of great importance in the healing process of the anterior cruciate ligament. However, I do not understand how a ligament, reconstructed out of fascia and tendon, is nourished when there is not a single vessel in it. There is no intermedial vessel, no synovial vessel. Could you explain how long revascularization takes and whether there is a revascularization or not? TRILLAT: This is a question of great importance, which I can answer with two considerations.
What this boy actually had was a torn anterior cruciate ligament, with the short capsular fibers and the long medial collateral fibers off the tibia; there was also meniscus rupture. You can see, it pays to talk to the patient. The time of the examination is quite important. It should be done as soon as you can get the patient to where you can do an adequate examination. This is just as true in reconstruction as it is in acute injuries. I can tell you the manner of my examination, but that does not necessarily mean that this must be your method.
However, there is other work that has been done where they feel that the capsule may remain reasonably intact, and you can tear a portion of the tibiocollateral ligament and get an valgus opening in the knee joint. o 'DONOGHUE: I think what is happening is the very thing that we were trying to prevent happening. We found it impossible to get any unanimity of opinion concerning classification until we knew what we meant by what we said. All this anatomic classification is only trying to describe what is happening, what is involved, and what instability is.
Late Reconstructions of Injured Ligaments of the Knee by K. P. Schulitz, H. Krahl, W. H. Stein (auth.), Professor Dr. Klaus-Peter Schulitz, Professor Dr. Hartmut Krahl, Dr. Wolfgang Hans Stein (eds.)