We present the operative technique and clinical results of concomitant reconstruction of the medial collateral ligament (MCL) and the posterior oblique ligament for medial instability of the knee using autogenous semitendinosus tendon with preservation of the tibial attachment. The semitendinosus tendon graft between the screw on the medial epicondyle and the tibial attachment of the graft was overlapped by the MCL, while the graft between the screw and the insertion of the direct head of the semimembranosus tendon was overlapped by the central arm of the posterior oblique ligament. Assessment was by stress radiograph and the Lysholm knee scoring scale. After a mean follow-up of 52.6 months (25 to 92), the medial joint opening of the knee was within 2 mm in 22 of 24 patients. The mean Lysholm score was 91.9 (80 to 100). Concomitant reconstruction of the MCL and posterior oblique ligament using autogenous semitendinosus tendon provides a good solution to medial instability.

OBJECTIVE. The purpose of this study was to examine the association between clinical features and MRI findings in adhesive capsulitis of the shoulder. MATERIALS AND METHODS. This study included 103 patients (41 men, 62 women) with adhesive capsulitis. The MRI findings were correlated with pain intensity, range of motion, and clinical stage. Joint capsule edema in the axillary recess, extracapsular edema, obliteration of the subcoracoid fat triangle, and effusion in the long head biceps tendon sheath were assessed by two radiologists using fat-suppressed T2-weighted images. Joint capsule thickness in the axillary recess and degree of external rotation during MRI were also measured. Intraclass correlation coefficient and kappa values were obtained. Associations between MRI findings and clinical features were assessed by statistical analyses. RESULTS. Anterior extracapsular edema was associated with range of motion on external rotation and abduction (p < 0.01). Joint capsule edema in the humeral portion of t...

OBJECTIVE. The purpose of this study was to show the usefulness of dynamic contrast-enhanced MRI (DCE-MRI) and to determine the optimal time window in MRI for differentiating between septic arthritis and transient synovitis in painful hip joints. MATERIALS AND METHODS. Eighteen patients who underwent DCE-MRI were enrolled, and the final diagnoses were septic arthritis (n = 7) and transient synovitis (n = 11). The enhancement patterns of DCE-MRI were dichotomized according to the shape of the time–signal intensity curves. The time at the maximal difference in the signal intensity between two time–signal intensity curves of both femoral heads was recorded. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Receiver operating characteristic curves were calculated. RESULTS. Six of seven patients with septic arthritis in the hip joint had decreased enhancement during the early phase of DCE-MRI. The enhancement difference between the two patient groups ...

Background: The purpose of the present study was to compare the clinical results of anterior cruciate ligament reconstruction with use of different grafts in patients with or without excessive joint laxity. Methods: We retrospectively studied eighty-three patients (forty-eight men and thirty-five women) who had undergone anterior cruciate ligament reconstruction between June 2002 and August 2004. Of the thirty-one patients who had generalized joint laxity, twenty were managed with an autologous bone-patellar tendon-bone graft and eleven were managed with a four-bundle hamstring (semitendinosus-gracilis tendon) graft. Of the fifty-two patients who had normal joint laxity, thirty-three were managed with a bone-patellar tendon-bone graft and nineteen were managed with a hamstring graft. Clinical results were evaluated by means of an examination at a minimum of twenty-four months after surgery. Results: Among the patients who had normal joint laxity, the mean side-to-side difference in anterior tibial translation on testing with the KT-2000 arthrometer at a minimum of twenty-four months postoperatively was 2.7 ± 1.9 mm in the bone-patellar tendon-bone graft group and 3.5 ± 1.7 mm in the hamstring graft group. This difference was not significant. The mean Lysholm score was 91 ± 7 points in the bone-patellar tendon-bone graft group and 85 ± 10 points in the hamstring graft group (p = 0.492). The side-to-side difference in anterior translation had an inverse correlation with the Lysholm score (β = –0.604, p < 0.001). Among the patients who had excessive joint laxity, the mean side-to-side difference in anterior tibial translation was 3.4 ± 1.5 mm in the bone-patellar tendon-bone graft group and 4.5 ± 2.0 mm in the hamstring graft group (p = 0.036). The mean Lysholm score was 89 ± 7 points in the bone-patellar tendon-bone group and 79 ± 12 points in the hamstring group (p = 0.015). The side-to-side difference in anterior translation had an inverse correlation with the Lysholm score (β = –0.708, p < 0.001). Conclusions: In patients who have excessive joint laxity, the two-year outcomes of anterior cruciate ligament reconstruction with bone-patellar tendon-bone grafts are better than those with four-bundle hamstring grafts in terms of both side-to-side anterior laxity and clinical results. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.