ObjectiveTo evaluate the safety of arthroscopic operation with artificial space on the buttocks for gluteal muscles contracture (GMC) by measuring the plasma osmolarity. MethodsBetween May and June 2011, 30 cases of GMC were joined in the study. Of them, 11 were male and 19 were female with an age range from 4 to 39 years (mean, 24.4 years). Twenty-eight patients had a definite history of repeat intragluteal injection. The disease duration ranged from 1-30 years (mean, 14 years). During operation, normal saline solution was used as lavage fluid, and radiofrequency energy was used as cutter for releasing GMC. The plasma sodium, plasma potassium, blood glucose, blood urea nitrogen concentrations, and plasma osmolarity were compared before and after operation; input and output volume of lavage fluid and intravenous dropping volume were recorded. Whether patients suffered from water intoxication or not was observed. The effect was evaluated through the criteria proposed by XIA Rongxi et al. ResultsThe operation was successfully completed in all patients, who had no water intoxication. The operation time was 16-70 minutes (mean, 33.4 minutes). The input volume was 2-23 L (mean, 6.3 L), the output volume was 2-22 L (mean, 5.8 L), and the absorption volume was 0.1-1.2 L (mean, 0.5 L); and the intravenous dropping volume was 350-1 300 mL (mean, 850 mL). No significant difference was found in plasma sodium, plasma potassium, blood glucose, blood urea nitrogen concentrations, and plasma osmolarity between before and after operations (P>0.05). All patients were followed up 3-26 months (mean, 12.7 months). At last follow-up, according to XIA Rongxi's et al evaluation standard, the results were excellent in 27 cases, good in 3 cases, and the excellent and good rate was 100%. ConclusionArthroscopic operation with artificial space on the buttocks is safe and reliable in the treatment of GMC.
ObjectiveTo observe the anatomical morphology of the tibial insertion of the anterior cruciate ligament (ACL) in Chinese adults so as to offer theoretical guidance for ACL reconstruction and meniscus transplantation. MethodsFifteen adult cadaveric knees (8 left knees and 7 right knees) were dissected, including 10 males and 5 females, with an age ranged from 25 to 47 years (mean, 32.4 years). All knees were generally observed through standard medial parapatellar approaches, then the ACL midsubstance and the tibial insertion (direct and indirect insertions) were anatomically measured. ResultsIn all specimens, the ACL was flat with a lot of fine fibers. The anteromedial bundle and posterolateral bundle could be observed in 13 of 15 knees. However, no obvious bundles were found in 2 knees. The arc-shaped tibial direct insertion started at the medial tibial eminence and ended at the anterior horn of the lateral meniscus. The width of the arc was (11.2±2.4) mm; the thickness was (3.0±0.3) mm; and the cross-sectional area was (28.8±7.8) mm2. And the left-right diameter of the whole insertion was (9.5±1.8) mm; anteroposterior diameter was (11.9±0.6) mm; and the cross-sectional area was (117.8±12.5) mm2. The width of the anterior horn of lateral meniscus was (12.3±2.0) mm. The anterior horn of lateral meniscus was surrounded by arc-shaped direct insertion in the middle, and its fibers were partly intertwined with indirect insertion of ACL. ConclusionAnatomical ACL reconstruction may therefore require a arc-shaped tibial footprint. There are overlap covering relationship between the attachment location of anterior horn of the lateral meniscus and tibial insertion of ACL. It should pay more attention to protecting tibial insertion of ACL in lateral meniscus transplantation.