Background and Objectives: The study addresses a significant limitation in applying bone-patellar tendon-bone (BTB) grafts in anterior cruciate ligament (ACL) surgery. By exploring the tubularization of grafts, the study extends the understanding of this surgical technique. The dual approach of the study—focusing on biomechanical properties using an animal model and postoperative outcomes in humans—offers a comprehensive perspective. Materials and Methods: The experimental cohort encompassed ten pairs of fresh porcine bone-tendon-bone grafts. One graft in each pair underwent modification through sutures that transformed the flat graft into a cylindrical structure. Testing determined the force required for the modified graft to rupture mechanically, expressed as N/mm², compared to conventionally prepared bone-tendon-bone grafts. The second phase of the research involved a prospective randomized clinical trial comprising 120 patients undergoing operative ACL reconstruction. For half the cases, grafts were tubularized using a random selection process. Clinical evaluations preoperatively and 12 months postoperatively employed the Tegner, Lysholm, and IKDC scoring scales for knee assessment. Results: Experiments showed that ligaments made using the tubularized surgical technique have statistically significantly higher values of measured force and higher maximum elongation values than ligaments made using the classical method. The clinical study concluded that there was no significant difference between the two groups of patients in the average score on the Tegner, Lysholm, and IKDC scales before and after surgery. Conclusions: The study results showed that suturing the graft does not negatively affect its biomechanical properties, and tubularization significantly increases the values of force required to cause rupture and the values of maximum elongation during rupture. Given the possibility of the one-year follow-up period being insufficient, future investigations should extend this period to acquire objective functional insights post-surgery.

Background and Objectives: The goal of this study was to evaluate the functional outcomes of patient treatment using an allograft after chronic locked posterior shoulder dislocation associated with a bony defect of the upper edge of the humerus that involves 25–50% of the articular surfaces. Materials and Methods: A total of 20 patients were included in this study. Electrocution was the cause of injury in eight patients; in ten patients, the cause was direct trauma; and in two patients, the cause of injury was a fall due to hypoglycemic coma. A standard deltoid pectoral approach was used and a fresh-frozen osteochondral allograft of the femoral condyle was applied. In evaluating the results, Constant’s scoring scale was used. Results: The average value of Constant’s point scale for the operated shoulder is 84.14 points. This result is good according to the average value of Constant’s point scale. Conclusions: Patients with locked chronic posterior dislocation in combination with a bony defect of the humeral head that covers 25–50% of the articular surface, in our opinion, should be treated using bone allografts rather than non-anatomical reconstruction methods.

Introduction. The purpose of this paper is to present and analyze the results of treatment of anterior soft-tissue shoulder instability using an open surgical technique with a minimally invasive anterior approach, as well as to emphasize the benefits of using an open surgical procedure in high-risk patients. Material and Methods. All patients underwent surgery at the Clinic of Orthopedic Surgery and Traumatology in Novi Sad in the period between January 2013 and September 2017. Out of 138 patients undergoing surgery for anterior shoulder instability, 40 patients came for follow-up examination. The average age of subjects was 27 ? 6. Medical history was taken from each patient and the range of motion and muscle strength of the operated shoulder was examined. The subjects filled out a questionnaire regarding the functional status of the operated shoulder, their experience in resuming sports activities, and their subjective feeling of pain. The Constant-Murley score was used to assess the postoperative results. Results. Postoperatively, the mean Constant-Murley score was 90.3 ? 11.5, while 87.5% patients had excellent and good results. Compared to the contralateral uninjured shoulder, there was a statistically significant difference (p < 0.05) in the Constant-Murley score, in external rotation of the abducted shoulder (13.2? ? 10.4?), as well as in shoulder adduction (10.25? ? 9.7?). Out of 35 patients who were athletes, 27 continued to actively engage in sports following the surgical treatment. Four patients had a re-dislocation (10%). Conclusion. Open surgical treatment of the anterior shoulder joint instability using a minimally invasive anterior approach is a reliable, time-tested procedure that provides favorable clinical results in young high-risk contact and overhead athletes with timely diagnosis and surgical care.