Impact of term after injury on the result of anterior cruciate ligament reconstruction
The operation of anterior cruciate ligament reconstruction is one of the most frequently performed in orthopedics. However, the proportion of failures remains at the level of 5–15 %, and the percentage of full recovery of physical activity of patients is 60–85 %. Actually, there are two main reasons for unsatisfactory results: damage to the graft with the formation of chronic instability and the development of post-traumatic arthrosis.
Objective is to determine the effect of the period of recovery of anterior cruciate ligament on the risk of developing post-traumatic gonarthrosis.
Methods: the long-term results of treatment of 527 patients operated 2 to 16 years ago were analyzed, according to the IKDC scale — in 367 (69.64 %). The progression of arthrosis was evaluated on the basis of the Kelgren-Lawrence classification in 225 patients (42.69 %). Variation-statistical analysis was performed using the software Statistica, version 13 (TIBCO Software Inc., License JPZ804I382130ARCN10J).
Results: in patients operated during the first 2 months after injury, the results of treatment by the IKDC scale turned out to be better (group A is fully normal — 68.9 % assigned). In persons whose reconstruction of the anterior cruciate ligament was carried out in a period from 2 months to 2 years after injury, the rate on the IKDC scale was 8 % less (p < 0.01). And among patients who were operated in 2 and more years after injury, only 48.6–50.0 % of cases were assigned to group A on the IKDC scale (p < 0.01). In the group of patients to whom anterior cruciate ligament was restored up to 2 months from the moment of injury, the minimum progression of gonarthrosis was determined (20.4 %); from 2 months up to 1 year — 39.1–40.6 %; more than a year — 57.1–68.8 %. The dependence of the progression of gonarthrosis on the period from the moment of injury to the surgical reconstruction of the anterior cruciate ligament is statistically proven.
Conclusions: the progression of gonarthrosis depends on the time elapsed from the moment of the injury to the surgical treatment anterior cruciate ligament reconstruction. Patients operated during the first 8 weeks after injury have a significantly lower probability of progression of gonarthrosis.
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