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Background: A partial rupture is likely secondary to the fact that the two bundles of the ACL have a synergistic yet distinctly different biomechanical function at different knee flexion angles. Recent interest focused on establishing pre and intraoperative ways of assessing the different types of symptomatic one bundle tears in order to perform an individual ACL augmentation. Treatment of partial ACL tears depends entirely on making an accurate diagnosis and determining degree of impairment. For some patients with partial tears, little morbidity is associated with the injury, and knee stability may be adequate for participation in sports and for all activities of daily living. Treatment in this scenario is largely supportive recommending that the patient take the time to recover from the initial injury and, after rehabilitation, to make a gradual return to sport. Operative intervention is needed in other cases, but such a decision should be taken while considering various factors, this includes: age, activity level, degree of laxity on physical examination, associated injuries, and symptomatic instability. Most clinicians would agree that symptomatic and debilitating instability require a more aggressive approach, likely in the form of operative intervention. The ACL augmentation is performed similar to a (traditional) single bundle technique while sparing the intact ACL fibers. This may support mechanical strength of the reconstruction, especially in the early postoperative period, and may maintain mechanoreceptors, neural elements and blood vessels to allow better proprioception, vascularization and an accelerated rehabilitation with faster return to sports. The aim of this study was to evaluate the results of arthroscopic reconstruction of partial ACL tears. Objectives: This work aims to evaluate the results of arthroscopic reconstruction of partial ACL tears. Materials and Methods: Twenty five patients with an ACL partial tear were included at this study; anatomic single bundle augmentation using the semi-tendinosus and gracilis auto-grafts was done. All cases (100%) were males. Of the knees involved, 15 were right (60%) and 10(40%) were left. Age ranges from 17 to 40 years and the mean age was 30.28± 5.38 years and the average time between the injury and the surgical interference was 4.6± 3.97 months. Affected bundle among patients was PL in 18 patients (72%) and 7 patients (28%) with affected AM bundle. Follow up on regular basis after reconstruction was done for two years postoperatively. Assessment was done before surgery and at the end of follow up using IKDC objective score, lysholm score, Tegner activity level scale and post operative KT -1000 measurements. Results: The overall results of the present study, as measured by the IKDC evaluation system after 24 months follow up, were 11 patients out of 25 patients (44%) had score A and 14 patients out of 25 patients (56%) had score B. The Lysholm score improved from a mean 63.08 ± 9.92 (before surgery) to 92.60 ± 3.88 at the end of follow up.Measurements by Tegner activity level scale (mean activity level before surgery was 5.1± 0.9, mean current activity level was 2.0 ± 0.9 and mean activity level after surgery improved to 5.1± 0.9). Measurements by postoperative K.T 1000 and evaluate the diff. between normal and injured knee after 24 months follow up, were 4 patients out of 25 patients (16%) were 1 m.m. diff., 10 patients out of 25 patients (40%) were 2 m.m. diff. and 11 patients out of 25 patients were 3 m.m. diff.). Conclusion: Diagnosis of symptomatic AM or PL bundle tear is a combination of the patient's history and complaints, clinical examination, MRI, and arthroscopic evaluation. Good results have been achieved with preserving the remanants of the torn ACL and performing augmentation but reliable diagnosis of partial torn ACL and assessing the vaidity of the remanants to be kept and decision to do an augmentation procedure has to be taken after arthroscopic assessment. [ABSTRACT FROM AUTHOR]

Purpose: Assessment of the functional and oncologic outcomes regarding endoscopic curettage of different benign bone tumor types within variable anatomic locations. Patients and methods: During the period between February 2012 and December 2016, 26 patients with symptomatic intra-osseous benign bony lesions were included. The age ranged from 3 up to 49 years (mean 20), of 14 females and 12 males. The follow-up duration ranged from 26 up to 58 months (mean 41). Functional scoring was done according to the Revised Musculoskeletal Tumour Society Rating Scale. Anatomic locations of the lesions included: 6 cases in the proximal tibia, 6 cases in the distal femur, 4 cases in the calcaneus, 3 cases in the proximal humerus, 3 cases in the distal tibia, 2 cases in the talus, 1 case in the proximal femur, and 1 case in the distal fibula. The procedure used 4 mm 30° scope for endoscopy, and high speed burrs 3.5–5 mm for extended curettage. Autogenous bone grafting was done in 5 cases, and adjuvant material (polymethylmethacrylate) was needed in 7 cases. Results: After exclusion of one case that was lost in the follow-up, the remaining 25 cases showed full functional recovery at a period of 8–12 weeks, and improved mean functional scores from 20.2 to 28.6/30 post-operatively, with p value

Treatment of segmental bone defects resulting from trauma or infection is extremely difficult. Bone segment transport with distraction osteogenesis and vascularized fibula transfer are the commonest used methods of treatment. Bone transport has problems with docking site. Vascularized fibula is technically demanding and hypertrophy occurs late. Induced membrane (Masquelet) technique is a relatively recent and simple treatment option consisting of two stages. A biological membrane is formed around cement spacer which is inserted in bone defect. In the second stage, the spacer is carefully removed and the membrane filled with autologous cancellous bone graft. From May 2013 to October 2015, we treated 20 patients with post-traumatic and post-infectious bone defect using Masquelet technique. There were 17 males and 3 females, with an average age of 38 years (range 12-64). The etiology of defect was open fractures in 6 cases (30%), infected non union in 11 cases (55%) and aseptic atrophic nonunion in 3 cases (15%). The mean size of bone defect after debridement was 7.2 cm. Soft tissue defect was present in 3 cases which was reconstructed. In the first stage involves thorough debridement, stabilization of the bone (either external or internal) and insertion of antibiotic cement spacer. 2nd stage was done after 4 to 8 weeks with insertion of morselized cancellous bone graft harvested from iliac bone, then tight closure done. 17 cases (85%) united, 2 cases (10%) of graft resorption and 1 case (5%) of infected graft. The time to union ranged from 4 to 11 months after 2nd stage with mean 7.4 months. In conclusion, induced membrane (Masquelet) technique is a safe, simple and reliable method for treating segmental bone defect. The major complications of this technique include infection and graft resorption.