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Introduction Anterior cruciate ligament reconstruction (ACLR) with autografts has been available for decades; however, the choice of graft is still debated. Here, we compared the functional outcomes of the two most widely used autografts, bone-patella tendon-bone (BPTB) and quadruple-stranded semitendinosus/gracilis (ST/G) autografts, at six months following ACLR. Materials and methods This prospective study was performed in the Department of Orthopedics of Yenepoya Medical College and Hospital located in Mangalore, Karnataka, India, a tertiary care institute over a period of 18 months (November 2018 to April 2020). The study included 38 adult patients who underwent ACLR and were randomly divided into two groups: BPTB autograft (n=19) or ST/G autograft (N=19). The patients were followed up at one-, three-, and six months. Postoperatively, surgical morbidity, knee stability functional outcome on Lysholm score, and knee range of motion (ROM) were assessed. Results The groups were homogenous and comparable regarding age, sex, side of ACL affected, duration of tear to treatment, and muscle wasting (all p-values > 0.05). At six months, the majority of the patients had a tibial translation of 0-2 mm on the Lachman test and anterior drawer test, and the groups did not differ significantly (both p-values > 0.05). Additionally, at six months, both groups demonstrated a significant increase in mean Lysholm score and mean ROM (both p-values < 0.001). However, the groups did not differ in mean Lysholm score and mean ROM at baseline and any of the follow-up visits (all p-values > 0.05). Conclusion At six months, ACLR with BPTB and ST/G autografts produced significant and comparable knee stability, functional outcome, and ROM.
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INTRODUCTION: Fractures of the distal radius in elderly patients are often associated with metaphyseal defects that can lead to collapse, malunion and therefore decreased function. An alternative approach to simple reduction is to fill the defects with materials that can provide structural support. METHODS: We used synthetic hydroxyapatite (HA) in unstable fractures of the distal radius in thirty-one elderly patients, of which four patients lost to follow-up, leaving twenty-seven patients for this study. All subjects underwent closed reduction with K-wire fixation and HA augmentation. They were followed up at 8- and 16-week intervals post-operatively to assess the functional outcome using patient-related wrist evaluation [PRWE], clinical outcome and radiological outcome. RESULTS: At mean 16 weeks, our results show that patients treated with this method showed no metaphyseal defect, no collapse and had satisfactory clinical outcome as assessed by PRWE. CONCLUSION: We believe that fixation with hydroxyapatite augmentation for fractures of the distal radius in elderly patients is an attractive therapeutic option. This experience has changed our clinical practice.