Les Deux Amis Op.41 - Score
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In zijn geboorteplaats is een straat naar hem vernoemd en ter herinnering aan de beroemde zoon van de stad een monument opgesteld. Uit Wikipedia, de vrije encyclopedie. Biographie op de internetpagina van de gezelschap van vrienden van Paul Lacombe.
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This Book have some digital formats such us :paperbook, ebook, kindle, epub, fb2 and another formats. Fernando Sor The ideas, which grow out of the instrument yet stand up well enough apart from it, are fresh and distinctive.
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The mean side-to-side difference in knee laxity was 2. At 1-year follow-up there were significant differences in KOOS outcome scores between the isolated PCL subgroup and the multiligament subgroup, but no differences at final follow-up. Despite the type of injury, there were only minor differences in knee laxity and subjective outcome scores between the isolated PCL group and the multiligament group.
The overall revision rate in this study was 5. Posterior cruciate ligament PCL reconstruction either isolated or in combination with other knee ligament reconstructions is rarely performed compared with anterior cruciate ligament ACL reconstruction. Despite this increase in anatomic and biomechanical knowledge, determining the best technique for PCL reconstruction has been limited by the low level of evidence provided by the small case series that have been published.
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Therefore, this study focuses on long-term follow-up of a large cohort of patients with injured PCLs treated with reconstruction at a single surgical center. An update of the current literature regarding treatment of PCL injuries was summarized by LaPrade et al 15 in The current literature on outcomes after PCL reconstruction focuses primarily on the different surgical techniques and therefore is based on case series. The reconstruction procedures include single-bundle or double-bundle techniques with either transtibial tunnel or tibial inlay techniques.
In the present study, only the transtibial PCL reconstruction technique was used. Clinical results after single-bundle PCL reconstruction were published in a systematic review by Kim et al 14 in When PCL reconstruction is performed in patients with multiligament injuries using the single-bundle transtibial technique, Fanelli and Edson 3 , 4 reported similar results.
Some studies also describe follow-up of patients with PCL reconstruction using the double-bundle transtibial technique. Spiridonov et al 30 found significant improvements in both subjective Cincinnati, IKDC and objective outcome scores in patients with either isolated or combined ligament injuries. Objective knee stability improved from 15 mm preoperatively to 0.
Other studies 15 also report significantly improved postoperative subjective outcome scores after isolated or combined transtibial double-bundle PCL reconstruction.
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A recently published systematic review by Qi et al 25 comparing single- versus double-bundle reconstruction showed no significant difference in clinical outcome but superior results in favor of the double-bundle technique in biomechanical studies. Therefore, there is still a need to gain more knowledge of the clinical outcomes after PCL reconstruction. The purpose of this study was to present the clinical and functional outcomes after PCL reconstruction either as an isolated or combined knee ligament reconstruction at a single referral center in a large study cohort. Our hypothesis was that patients with isolated PCL injuries have superior postoperative subjective outcome scores and less side-to-side difference in knee laxity after PCL reconstruction than patients with combined PCL injury in a multiligament-injured knee.
A total of patients who underwent PCL reconstruction between and were retrospectively identified. We excluded 34 patients for final follow-up. PCL reconstruction was performed either isolated or in combination with reconstruction of other knee ligaments. Patients with grade I and II instability were excluded.
The preoperative diagnoses were made using a combination of clinical examination, stability testing including knee laxity measurement KT , and magnetic resonance imaging. These patients were invited for clinical follow-up final follow-up between and We collected data from our own database.
Medical history and surgical data were collected through patient files. None of the patients were offered PCL reconstruction in the acute phase after trauma within 6 weeks of injury.
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Patients with isolated PCL injuries were referred to our center due to instability symptoms and therefore most often diagnosed later. Patients with PCL injury in combination with collateral ligament injury were treated using a hinged brace for 6 weeks before surgery was performed. The causes of injury in this cohort were, in most cases, related to trauma secondary to traffic accidents Other causes of PCL injury were activities of daily living The initial cause of injury was unknown in 5.
The preoperative evaluation and 1-year follow-up were, in the majority of cases, performed by the surgeon. All patients were invited to our clinic for a prospective follow-up in or At follow-up, a standardized objective clinical examination by independent experienced physiotherapists was performed. Subjective scores were completed by the patients without investigator assistance. Patients not available for clinical examination completed subjective and complication data questionnaires. Patients were evaluated using the validated KOOS score 28 preoperatively, at 1 year, and at final follow-up.
At follow-up, IKDC objective and patient subjective assessment scores were obtained. The Tegner activity score 31 was used in the assessment of knee functionality and activity level. Furthermore, we performed subgroup analyses regarding sex, surgical technique single- vs double-bundle , and type of graft used allograft vs autograft. Knee laxity was measured as the side-to-side difference in anterior and posterior translation of the tibia using the KT arthrometer MEDmetric. This method for determining explosive power has been proven safe and suitable for all age groups and physical fitness levels.
This test was performed with the patient seated and takes 0. All surgical procedures were performed by 5 experienced senior consultants. The standard ACL reconstruction technique used in this cohort was a transtibial technique with attempts to place the graft in the native ACL footprint. Postoperatively, all patients were immobilized in a hinged brace for 8 weeks.
During the remaining 2 weeks, the patients initiated weightbearing activities and gradually increased motion as tolerated. Differences between preoperative and postoperative patient-reported outcome measure values and knee laxity were analyzed using the Student t test and the chi-square test. Knee injury and Osteoarthritis Outcome Score KOOS results at preoperative, 1-year follow-up, and final follow-up for the entire patient group undergoing posterior cruciate ligament reconstruction.
ADL, activities of daily living; QoL, quality of life.