Patellar tendon autografts are used daily by orthopaedic surgeons for anterior cruciate ligament (ACL) reconstruction because they are known to give good and easily reproducible clinical results. The first surgeon who used part of ligamentum patellae for ACL replacement was Langworthy, in 1930s. Thirty years later Jones and Brückner refined the initial technique by using the central third of the patellar tendon. Following Franke’s publication, BTB became one of the most popular graft sources and gained further popularity both in Europe and United States, through the work of Eriksson and Clancy.
The use of bone-patellar tendon-bone graft(BTB) is associated with 80-90% excellent clinical results, and some complications of the knee extensor mechanism, including BTB harvest site morbidity and disruption of the knee extensor apparatus. Bone-patellar tendon-bone graft it ensures strong initial graft fixation using interference screws, allowing direct bone-bone healing and consecutive bony integration at the fixation points of the reconstruction. The main disadvantage of BTB is a graft–tunnel mismatch due to a smaller cross-section area and incomplete filling of the tunnel compared to hamstring tendon graft.
This paper presents fundamental principles of knee arthroscopy. The paper discusses the techniques of this surgical procedure, its advantages and potential complications. This is all presented using own material covering the period between 1993 and 2024 and including over 6,000 ACL reconstructions.

Objective: To compare the clinical results of meniscus allograft transplantation(MAT) between patients with dis- coid lateral meniscus(DLM)and patients with nondiscoid lateral meniscus(NDLM).Methods: A total of 106 patients with later- al discoid meniscus or lateral nondiscoid meniscus who underwent unilateral MAT from January2005 to December 2017 were included in the study. All patients were followed up for at least two years. Clinical outcomes were assessed by range of motion(ROM), visual analogue scale(VAS), International Knee DocumentationCommittee(IKDC) subjective score,Lysholm score and Tegner activity score. Magnetic resonance imaging was performed to evaluate the condition of plant and cartilage. Results: There was no significant difference in ROM,IKDC, Lysholm, Tegner and VAS before the operation between DLM group and NDLM group (P>0.05). Except for ROM, the above clinical evaluation indexes were improved at final follow-up visit co- mpared with that before operation in both groups (P<0.05). According to functional scores of final follow-up visit, IKDC, Lysholm and VAS were better in NDLM group than in DLMgroup, while Tegner score had no statistically significant differ- ence between the two groups. The mean meniscal extrusion was (3.653±0.705) mm in DLM group and (3.074±0.850) mm in NDLMgroup, and the difference was not statistically significant (P>0.05)。Conclusions:MAT is effective in treatment of both serious lateral discoid meniscus injury and lateral nondiscoid meniscus injury with knee function significantly improved , how- ever, the efficacy of the latter is better than that of the former. The reason is still required further study and the difference should be informed to the patients.

Introduction. Reestablishing optimal knee muscle strength following anterior cruciate ligament (ACL) reconstruction poses a persistent challenge. In certain cases, a patient's desire to resume pre-injury levels of activity prompts individuals to push their body over the boundaries of their rehabilitation regimen. This may compromise surgical outcomes, underscoring the imperative for additional support in our technique to meet the high expectations of our patients.
Materials and Methods. We performed a retrospective descriptive study of all ACL reconstructions performed in professional or highly demanding recreational athletes using the all-inside technique with internal brace reinforcement between January 2020 and March 2024 at our department. Excluded were the patients in whom revision ACL surgery was performed. Patient-reported outcomes were evaluated with the International Knee Documentation Committee (IKDC) Score.
Results. Fifty patients (50 knees) were included in the study. All patients were between 19 and 24 years of age. Two patients required medial meniscus repair due to concomitant injury. There we no complications in the form of chronic synovitis or prolonged joint effusion. Up to this point, there was only one instance of chronic infection. The mean IKDC score was 76.9 at three months and 91.9 at six months follow-up.
Conclusion. The internal brace serves as a safeguard for reconstructed ACL, especially in the early stage assuring it matures properly without excessive stretching, thereby providing an additional degree of protection from graft failure. This reduces the time between surgery and the commencement of strengthening exercises, offering an additional assurance of success for high-demanding patients.

Introduction: Essex Lopresti fracture-dislocation is a rare and often overlooked injury of the upper limb. While this condition is typically seen in older patients, it can also occur in younger individuals, posing a diagnostic and therapeutic challenge.

Methods: We report the case of a 36-year-old man, with no prior medical history, who sustained a closed forearm trauma following a traffic accident. He complained of right wrist pain and total functional impairment of the limb. X-rays revealed a proximal radius fracture with distal radio-ulnar dislocation suggestive of Essex Lopresti fracture-dislocation.

Results: The patient underwent surgery with reduction of the radio-ulnar dislocation and fixation with k wires followed by radial head resection. Follow-up included pin removal at 6 weeks postoperatively. At the last follow-up, 18 months postoperatively, the patient exhibited near-complete mobility of the elbow and wrist with a good Quick-DASH score.

Discussion: Essex Lopresti fracture-dislocation in young patients is rare but can have significant functional consequences. Surgical management may involve radial head resection with the risk of minimal to substantial loss of elbow mobility or radial head prosthesis offering good mobility at the expense of prosthetic implant lifespan, especially in young individuals.

Conclusion: Appropriate diagnosis and surgical management of Essex Lopresti fracture-dislocation optimize functional outcomes and reduce the risk of medium- to long-term complications, particularly in the young population with high functional demands.