Results of anterior cruciate ligament restoration using «all inside» techniques

Authors

DOI:

https://doi.org/10.15674/0030-59872017284-91

Keywords:

knee, anterior instability, ligament plastics

Abstract

In spite of the new technology, the number of unsatisfactory results of anterior cruciate ligament reparation is not to be re­duced. Improving of techniques goes by two directions: decreas­ing of surgical traumatization and improving the anatomical position of transplant.

Objective: to evaluate the effectiveness of recovery by anterior cruciate ligament «all inside».

Methods: results of anterior cruciate ligament restoring «all in­side» in 346 patients (201 men, 145 women) operated in the pe­riod 2013–2015 analyzed. Average age: 20 years — 75 pa­tients, 21– 30 — 116, 31–40 — 101, over 40 — 54. Drilling tool RetroDrill made channels or FlipCutter were used, fixation in the femur and tibia using system TightRope or equivalent.

Results: the recurrence of instability appeared in 3 patients, 2 cases — stable reactive synovitis. Pain at the site of the im­plants and their removal was not observed. Performance on a scale IKDC were: A-162, B-34, C-15, D-3. The main ad­vantages of the method include a significant reduction in pain (VAS score on 1–3 on the 2nd day); rapid r ecovery o f range of motion; no hematomas at the site exit channel tibia bone; employment of a single tendon only 92 % of cases, preservation of function m. gracilis, absence of implant in bones channels, which is important when you perform revision surgery.

Con­clusions: the method of anterior cruciate ligament reparation using technology «all inside» with fixing system type TightRope is the similar to other technologies and provides positive results in patients with anterior instability of the knee joint.

Author Biographies

Maksim Golovakha

Zaporizhzhia State Medical University. Ukraine

MD, Prof.

golovaha@ukr.net

 

Sergiy Krasnoperov

Zaporizhzhia State Medical University. Ukraine

MD, PhD

krasnoperovserg@gmail.com

 

 

Rostyslav Titarchuk

Clinic of modern surgery «Garvis», Dnipro. Ukraine

ros.titarchuk@rambler.ru

 

 

Ivan Zabielin

CI «Zaporizhzhia Regional Clinical Hospital». Ukraine

MD, PhD

zabelin-ne@inbox.ru

 

 

Anatoliy Tverdovsky

CI «Zaporizhzhia Regional Clinical Hospital». Ukraine

tverdovskyi.a.o@gmail.com

 

 

Weniamin Orljanski

Vienna Private Clinic. Austria

MD, Prof.

orljanski@hotmail.com

 

 

References

  1. Golovakha ML, Orljanski W, Tytarchuk RV, Zasypko IA, Banit OV, Benedetto KP. Аnalysis of the outcomes of different methods for graft fixation at the plasty of the anterior cruciate ligament. Orthopaedics, Traumatology and Prosthetics. 2015;(2):53–9. doi: 10.15674/0030-59872015253-59. (in Russian)
  2. Kostrub AA. Rehabilitation after arthroscopic operations. Kiev: TOV Publishing company «Nash Format», 2015. 272 p. (in Russian)
  3. Roy IV, Bogdan SV, Bayandina ОI, Kostogryz O.O. Treatment of the patellofemoral pain syndrome in patients after anterior cruciate ligament revision recostruction. Visnyk Ortopedii, Travmatologii ta Protezyvannya. 2015;(1):21–6. (in Ukrainian)
  4. Orljanskiy V, Golovaha ML. Manual on arthroscopy of the knee joint. Zaporizhzhya: Prosvita, 2016. 264 p. (in Russian)
  5. Krasnoperov SN, Didenko IV, Titarchuk RV, Gricenko AA, Golovakha ML. Restructuring of anterior cruciate ligament transplant according to MRI data Orthopaedics, Traumatology and Prosthetics. 2016;(4):48–54. doi: 10.15674/0030-59872016455-61. (in Russian)
  6. Golovakha ML, Banit OV, Titarchuk RV, Zasypko IA, Didenko IV, Orlyanskiy W. Results of restoration of complex injuries in ligamentous apparatus of the knee joint. Orthopaedics, Traumatology and Prosthetics. 2015;3:76–86. doi: 10.15674/0030-59872015378-86. (in Russian)
  7. Klimovitskiy VG, Tyazhelov AA, Goncharova LD, et al. Results of conservative treatment ligament injuries of knee joint. Trauma. 2012;13(1):79–82. (in Russian)
  8. Karpinski MYu, Karpinskaya ED, Schikota RА, Tyazhelov AA, Goncharova LD. Results damage modeling ligamentous apparatus of the knee. Trauma. 2012;13(3):164–171. (in Russian)
  9. Strafun SS, Sergienko RA, Strafun AS, Bogdan S. Prediction of results in treating patients with anterior instability of the knee joint. Orthopaedics, Traumatology and Prosthetics. 2012;2:64–7. doi: 10.15674/0030-59872012264-67. (in Russian)
  10. Walsh MP, Wijdicks CA, Parker JB, et al. A comparison between a retrograde interference screw, suture button, and combine fixation on the tibial side in all-inside anterior cruciate ligament reconstruction: a biomechanical study in a porcine model. Am J Sport Med. 2009;37:160–7. doi: 10.1177/0363546508323747.
  11. Nyland J, Mattocks A, Kibbe S, Kalloub A, Greene JW, Caborn DN. Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update. Open Access J Sports Med. 2016;7:21–32. doi: 10.2147/OAJSM.S72332.
  12. Cha PS, Brucker PU, West RV, Zelle BA, Yagi M, Kurosaka M, Fu FH. Arthroscopic double-bundle anterior cruciate ligament reconstruction: an anatomic approach. Arthroscopy. 2005;21(10):1275. doi: 10.2147/OAJSM.S72332.
  13. Morey VM, Nag HL, Chowdhury B, Pannu CD, Meena S, Kumar K, Palaniswamy A. Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction: Our experience with follow-up of 4 years. J Clin Orthop Trauma. 2016;7(1):17–22. doi: 10.1016/j.jcot.2015.06.003.
  14. Debieux P, Franciozi CE, Lenza M, Tamaoki M, Magnussen R, Faloppa F, Belloti J. Bioabsorbable versus metallic interference screws for graft fixation in anterior cruciate ligament reconstruction. Cochrane Database Syst. Rev. 2016;7:CD009772. doi: 10.1002/14651858.CD009772.pub2.
  15. Caprini JA. Identification of patient venous thromboembolism risk across the continuum of care. Clin. Appl. Thromb. Hemost. 2011;17(6):590–9. doi: 10.1177/1076029611404217.
  16. Karikis I, Desai N, Sernert N, Rostgard-Christensen L, Kartus J. Comparison of Anatomic double- and single-bundle techniques for anterior cruciate ligament reconstruc¬tion using hamstring tendon autografts: a prospective randomized study with 5-year clinical and radiographic follow-up. Am J Sports Med. 2016;44(5):1225–36. doi: 10.1177/0363546515626543.
  17. Biswal UK, Balaji G, Nema S, Poduval M, Menon J, Patro DK. Correlation of tunnel widening and tunnel positioning with short-term functional outcomes in single-bundle anterior cruciate ligament reconstruction using patellar tendon versus hamstring graft: a prospective study. Eur J Orthop Surg Traumatol. 2016;26(6):647–55. doi: 10.1007/ s00590-016-1809-4.
  18. Sharma A, Flanigan DC, Randall K, Magnussen RA. Does gracilis preservation matter in anterior cruciate ligament reconstruction? A systematic review. Arthroscopy. 2016;32(6):1165–73. doi: 10.1016/j.arthro.2015.11.027.
  19. Leiter JR, Gourlay R, McRae S, de Korompay N, MacDonald PB. Long-term follw-up of ACL reconstruction with hamstring autograft. Knee Surg Sports. Traumatol Arthrosc. 2014;22:1061–69. doi: 10.1007/s00167-013-2466-3.
  20. Papalia R, Maffulli N, Denaro V. The anterior cruciate ligament remnant: to leave it or not? Arthroscopy. 2013;29(11):1736–37. doi: 10.1016/j.arthro.2013.03.078.
  21. Mohtadi NG, Chan DS, Dainty KN, Whelan DB. Patellar tendon versus hamstring tendon autograft for an¬terior cruciate ligament rupture in adults. Cochrane Database Syst. Rew. 2011;9. doi: 10.1002/14651858.CD005960.
  22. Magnussen RA, Verlage M, Flanigan DC, Kaeding CC, Spindler KP Patient-reported outcomes and their predictors at minimum 10 years after anterior cruciate ligament reconstruction: a systematic review of prospectively collected data. Orthop J Sports Med. 2015;3(3):2325967115573706. doi: 10.1177/2325967115573706.
  23. Ruano JS, Sitler MR, Driban JB. Prevalence of radiographic knee osteoarthritis after anterior cruciate ligament reconstruction, with or without meniscectomy: an evidence-based practice paper. J Athl Train. 2016. doi: 10.4085/1062-6050-51.2.14.
  24. Sasaki S, Tsuda E, Hiraga Y, Yamamoto Y, Maeda S, Sasaki E, Ishibashi Y. Prospective randomized study of objective and subjective clinical results between double-bundle and single-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 2016;44(4):855–64. doi: 10.1177/0363546515624471.
  25. Murphy MV, Du DT, Hua W, Cortez KJ, Butler MG, Davis RL, DeCoster TA, Johnson L, Li L, Nakasato C, Nordin JD, Ramesh M, Schum M, Von Worley A, Zinderman C, Platt R, Klompas M. Risk factors for surgical site infections following anterior cruciate ligament reconstruction. Infect Control Hosp. Epidemiol. 2016;37(7):827–33. doi: 10.1017/ice.2016.65.
  26. Ozturk BY, Maak TG, Fabricant P, Altchek DW, Williams RJ, Warren RF, Cordasco FA, Allen AA. Return to sports after arthroscopic anterior stabilization in pa¬tients aged younger than 25 years. Arthroscopy. 2013;29(12):1922–31. doi: 10.1016/j.arthro.2013.09.008.
  27. Tibor L, Chan PH, Funahashi TT, Wyatt R, Maletis GB, Inacio MC.Surgical technique trends in primary ACL reconstruction from 2007 to 2014. J Bone Joint Surg Am. 2016;98(13):1079–89. doi: 10.2106/JBJS.15.00881.
  28. Thompson SM, Salmon LJ, Waller A, Linklater J, Roe JP, Pinczewski LA. Twenty-year outcome of a longitudinal prospective evaluation of isolated endoscopic anterior cruciate ligament reconstruction with patellar tendon or hamstring autograft. Am J Sports Med. 2016;44(12):3083–94. doi: 10.1177/0363546516658041.
  29. Yoshiya S. editorial commentary: all-inside anterior cruciate ligament reconstruction can afford satisfactory clinical outcome and functional stability. Arthroscopy. 2016;32(2):338. doi: 10.1016/j.arthro.2015.12.016.

How to Cite

Golovakha, M., Krasnoperov, S., Titarchuk, R., Zabielin, I., Tverdovsky, A., & Orljanski, W. (2017). Results of anterior cruciate ligament restoration using «all inside» techniques. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (2), 84–91. https://doi.org/10.15674/0030-59872017284-91

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Section

ORIGINAL ARTICLES