A collection of complex joint preservation and replacement case studies and random thoughts of a orthopedic surgeon essentially aimed at knowledge dissemination.
Saturday 13 July 2013
Oops! post acl recon
The patient feels that his knee is not right. He has a 3 degree ffd, full flexion
If one looks at the lateral the femoral tunnel is anterior and the tibial tunnel looks anterior to the blumensats's line suggesting notch impingement with resultant loss of extension. The anterior femoral tunnel can cause loss of flexion. Luckily the patient has only loss of extension terminally with no instability and does not want any surgical intervention due to loss of confidence in orthopaedic surgeon as the surgeon said everything is ok.
He already has medial compartment OA with a vertical femoral tunnel. I would loved to revise the graft with a high tibial osteotomy to buy time. Other probably would do only an hto and play on the slope ( increase the slope )
If one looks at the lateral the femoral tunnel is anterior and the tibial tunnel looks anterior to the blumensats's line suggesting notch impingement with resultant loss of extension. The anterior femoral tunnel can cause loss of flexion. Luckily the patient has only loss of extension terminally with no instability and does not want any surgical intervention due to loss of confidence in orthopaedic surgeon as the surgeon said everything is ok.
ReplyDeleteHe already has medial compartment OA with a vertical femoral tunnel. I would loved to revise the graft with a high tibial osteotomy to buy time. Other probably would do only an hto and play on the slope ( increase the slope )