Background: Early detection and treatment of extensor mechanism rupture are essential for a long-term functional Knee joint. In chronic cases, quadriceps muscle retraction and contracture make surgery difficult and results are less predictable. Objectives: The purpose of this study was to evaluate outcomes in the cases of late repaired patellar tendon rupture. Methods: This study included patients with chronic patellar tendon rupture who were operated at Shafa orthopedic hospital from 2006 to 2013. Results: A total of ten patients were evaluated, wirh 12 cases of chronic patellar tendon rupture. Patients had a mean age of 34. 4 years (range 18-58). Seven cases were caused by a traffic accident and three by a fall. The mean length of time from injury to surgery was 23 months (range 3-132). The mean time of follow-up was 6. 2 years (range 3-9). Cerclage wire reinforcements were applied in nine of the Knees and three Knees had fiber wire reinforcement. Tendon graft augmentation was applied in ten of the Knees; six with semitendinosus and gracilis autograft, two with semitendinosus autograft, one with an Achilles tendon allograft, and one with a tibialis anterior allograft. Means for preoperative/postoperative active Knee range of motion, extension lag, subjective International Knee Documentation Committee Score, and modified Cincinnati Scores were 81/117, 32/2, 22. 7/84. 5 and 24/87, respectively. Wire breakage was seen on all nine Knees but wires were removed in only two symptomatic cases. Conclusions: Good to excellent results were obtained in terms of functioning with operative treatment of chronic patellar tendon rupture. Direct repair with autogenous or allogenic graft augmentation and cerclage wire reinforcement and postoperative cast immobilization are recommended.

Objectives: To translate and evaluate the test-retest reliability, internal consistency and construct validity of the Persian version of the IKDC questionnaire in Iranian patients after ACL and meniscal operations.Materials & Methods: After translation based on the Quality Of Life Assessment protocol, the IKDC, KOOS and SF-36 Health Survey were administered to a sample of 101 patients underwent for ACL and meniscal operations. The test-retest reliability was tested by use of an Intra-class Correlation Coefficient, the internal consistency by a Crohnbach’s alpha and the construct validity were tested by correlating the IKDC Scores with KOOS subscales including pain, symptoms, ADL, recreations and sport activity, Quality Of Life and the physical and mental component summaries and the SF-36 Health Survey. In addition, the construct validity was measured by Pearson and Spearman correlation coefficient parameters.Results: A high test-retest reliability Score was found with an ICC of 0.99. The Internal consistency was as 0.90. A moderate to good correlation was obtained between the IKDC total Score and KOOS subscales, including pain (r=0.66, P<0.001), symptoms (r=0.55), ADL (r=0.68), sport and recreation activities (r=0.60) and Quality Of Life (r=0.50). A good correlation was found between the total Scores of the IKDC and physical component summary (r=0.70) along with another fair association between the mental component summaries of the SF-36 Health Survey (r=0.44).Conclusions: Persian version of the IKDC is a reliable and valid instrument for designing any assessment or rehabilitation program in Iranian patients after ACL and meniscal Surgery.

Operative results of arthroscopic open ACL reconstruction in 32 patients by bone-patellar tendon-bone graft was evaluated in shariaty hospital from 1997 to 2000. For assessment we used criteria developed by International Knee Documentation Committee. Signs and symptoms of the patients, their satisfaction and activity level in preoperative and postoperative period were assessed. The IKDC Score, signs and symptoms were significantly improved following surgery. One patient showed failure of fixation. Ninety one percent of patients were satisfied with subjective evaluation of normal or near normal. The type of operation (open or arthroscpic), associated meniscal tear, age of the patients and time interval between rupture and reconstruction had no effect on the result but in patients with a quadriceps atrophy in postoperative period, caused result decline.

Objectives: The aim of the present study was to compare the performance of the vertical jump task and the level of disability between the coper and non-coper athletes with an anterior cruciate ligament-minus Knee.Methods: Thirty-four professional male athletes with isolated complete anterior cruciate ligament -tear (age 20-29 years and 6-12 months time past injury) were recruited in this study. The subjects were allocated into the coper (n=17) and non-coper (n=17) groups according to their history of having giving way and feeling an instability in their injured Knee. The maximum vertical jump height was recorded by a 6-camera Vicon motion analysis system. The functional outcomes of the subjects were assessed with use of the Persian versions of the International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score and Tegner Questionnaires.Results: The results revealed that the coper ACK-deficient Knee subjects had a significantly higher International Knee Documentation Committee Score as well as two subscales of the KOOS questionnaire including the sports (p=0.001) and the quality of life (p=0.016) than non-copers. However, the subscales of pain (p=0.0137), symptoms (p=0.353) and the activities of daily living (p=0.133) of the KOOS questionnaire did not show any significant differences between the coper and non-coper ACL-deficient Knee subjects. In addition, the maximum jumping height was significantly higher in the copers too (p=0.008).Discussion: While the pain, symptoms and daily activities were not different between the two groups, a higher level of the functional abilities, sports activities, quality of life and the maximum jumping height were shown in the coper ACL-deficient Knee subjects when compared to the non-copers. A deliberate evaluation of the functional abilities in ACL-deficient Knee subjects might play a key role in distinguishing the coper and non-coper ACL-deficient Knee subjects.

Background: Anterior Cruciate Ligament (ACL) is one of the main Knee stabilizing ligaments. Because of high incidence of ACL tearing especially in young athletes its reconstruction is very important. The aim of this study was to evaluate short-term results of anterior cruciate ligament ruptures using four strand hamstring auto graft and Bone patellar tendon autograph.Methods: The study group included 96 patients (3 female and 93 male) with ACL teared who had been referred to our center in 5 years period (2002-2007). The subject which were Accessed in this study included meniscal injury concomitant chondral injury, determine the most common cause of ACL tearing, comparision of IKDC and lysholm Score in all patients before and after surgery, and limitation of rang ofmotion of Knee  post operation. Results: Involvement was in the right Knee in 38 patients and in the left Knee in 58 patients. Mean age of patients was 27.6 years (19-48). Mean surgical delay was 18 month (1-77). The most common cause of tear was playing soccer. Meniscal injury was in 78 patients. (Medial meniscus in 63 patients, lateral meniscus in 29 patients) Concommitent chondral injury was in 54 patients (56.25%). 68% of patients returned to preoperative functions sport activity. There was no limitation in extension and there was 6 patients limitation in flexion about 20º. In last visit of patients IKDS in class A and B was 96. Conclusion: It is seem that arthroscopic reconstruction of ACL is a safe and good method in treatment of Knee stability. Use of IKDC and lysholm Score for comparision of patients before and after surgery is helpful. The operation should be done early after injury. Reconstruction of ACL in older patients in the abscense of DJD is effective.

Objective Postoperative rehabilitation protocols, such as immobilization and non-weight-bearing periods during the acute phase after anterior cruciate ligament (ACL) surgery vary depending on the surgeon or the institution and lack clear standardization. Weight bearing (WB) after ACL reconstruction (ACLR) is critical. This study compares the results of WB immediately after surgery and partial WB with a brace after ACLR. Materials & Methods In this randomized clinical trial, the block random sampling method was used to select 84 patients who were divided into two groups. Group 1 was allowed to have full WB after surgery and Group 2 was asked to use braces after surgery, and they were divided into partial WB for one month and then full WB. Meanwhile, demographic information was recorded. The Lachman test, anterior Knee pain, and Kneeling pain before and one month after the surgery were also recorded. Knee function was evaluated using the International Knee Documentation Committee, Knee injury and osteoarthritis outcome Score, and Lysholm scales before surgery and 1, 3, and 6 months after surgery. The data were analyzed using the SPSS software, version 20, and the Fisher exact test, the chi-square test, the Friedman test, and repeated measures analysis of variance. Results Most of the patients were men under 30 years of age. There was no statistically significant difference in the demographic information of the patients in the two groups. Kneeling pain, anterior Knee pain, and the Lachman test did not differ between the two groups one month after the surgery. There was no difference between the two groups in the Scores using the International Knee Documentation Committee, Knee injury and osteoarthritis outcome Score, and Lysholm Score in the 6-month follow-up. All the examined indicators in each group improved over time. Conclusion WB immediately after surgery compared to partial WB at 1, 3, and 6 months after ACLR do not differ; therefore, patients can bear full weight if they tolerate it.

Objective Postoperative rehabilitation protocols, such as immobilization and non-weight-bearing periods during the acute phase after anterior cruciate ligament (ACL) surgery vary depending on the surgeon or the institution and lack clear standardization. Weight bearing (WB) after ACL reconstruction (ACLR) is critical. This study compares the results of WB immediately after surgery and partial WB with a brace after ACLR. Materials & Methods In this randomized clinical trial, the block random sampling method was used to select 84 patients who were divided into two groups. Group 1 was allowed to have full WB after surgery and Group 2 was asked to use braces after surgery, and they were divided into partial WB for one month and then full WB. Meanwhile, demographic information was recorded. The Lachman test, anterior Knee pain, and Kneeling pain before and one month after the surgery were also recorded. Knee function was evaluated using the International Knee Documentation Committee, Knee injury and osteoarthritis outcome Score, and Lysholm scales before surgery and 1, 3, and 6 months after surgery. The data were analyzed using the SPSS software, version 20, and the Fisher exact test, the chi-square test, the Friedman test, and repeated measures analysis of variance. Results Most of the patients were men under 30 years of age. There was no statistically significant difference in the demographic information of the patients in the two groups. Kneeling pain, anterior Knee pain, and the Lachman test did not differ between the two groups one month after the surgery. There was no difference between the two groups in the Scores using the International Knee Documentation Committee, Knee injury and osteoarthritis outcome Score, and Lysholm Score in the 6-month follow-up. All the examined indicators in each group improved over time. Conclusion WB immediately after surgery compared to partial WB at 1, 3, and 6 months after ACLR do not differ,therefore, patients can bear full weight if they tolerate it.

Background: Graft type selection is still a controversial issue in anterior cruciate ligament (ACL) reconstruction. The type of graft is a determinant of return to sport and its quality. Objectives: This study aims to evaluate results and rate of return to sport using quadriceps autograft compared to hamstring autograft. Methods: The present prospective cohort study investigated the results of using quadriceps and hamstring autografts in athletes with an ACL tear. Our variables included age, sex, and body mass index, type of sports activity, infection, meniscus tear and chondral lesion, time and quality of return to sport, range of motion, KT-1000, Lachman and Knee injury and osteoarthritis outcome Score, International Knee Documentation Committee grade, and Lysholm Score. Results: A total of 71 out of 139 studied patients were operated on hamstring autografts and 68 patients by quadriceps autografts. The patients showed no significant differences (P>0. 05) in terms of age, sex, body mass index, sports group, and meniscus tear. In the final follow-up, the chondral lesion was 26. 47 vs 16. 90, anterior Knee pain was 5. 8 vs 2. 81, and the return to sport was 71. 64 vs 78. 87 in the quadriceps group vs the hamstring group. The extension loss involved 2 patients per group. The Scores of the International Knee Documentation Committee and Knee injury and osteoarthritis outcome, the Lysholm test, KT-1000, and the Lachman test had no significant differences in the two groups. Conclusion: The results of the present study indicated that the use of both quadriceps and hamstring autografts was appropriate for the ACL tear. Also, the orthopedic surgeon should be responsible for deciding to select one of the two grafts.