The results of polypropylene mesh application at anterior cruciate ligament reconstruction
Keywords:ACL reconstruction, tendon graft, polypropylene, patients
AbstractAnterior cruciate ligament (ACL) repair remains one of the most common surgeries in orthopedics and traumatology. The evolution of the ACL repair technique continues, new fixators appear, and the position of the graft, its shape and size are modified. Semi-tendon and gracilis muscle (STG) grafts are the most common used due to low-trauma and technically simple method of obtaining. Its disadvantage is a long period of intratunnel incorporation, one of the ways of this acceleration is the implantation of a polypropylene mesh. In an experiment on rabbits, we proved its positive effect. Objective. To develop a method of improving the intratunnel incorporation of STG-graft at ACL repair of the knee joint using polypropylene mesh. Methods. Results of 75 patients were analyzed. The study group consisted of 35 patients who underwent surgery during 2018–2019 using polypropylene mesh, comparative group — 40 patients who had surgical treatment in 2017. Evaluated demographic data, pre-operation period, recovery functions, complications rate, data of KOOS and IKDC scales. Results. Non-specific data of the inflammatory process (CRP and ESR) did not change significantly in patients with inserted polypropylene mesh. They did not have more pronounced pain after surgery, there were less cases of reactive synovitis with significantly minimized the number of the knee joint punctures. Restorationof knee function was faster, and early weight bearing of the leg allowed up to 6 months. Better results by the KOOS and IKDC scales received after surgery. Conclusions. Implantation of polypropylene mesh around the intratunnel part of STG-graft at ACL repair surgery did not increase the complications rate and allowed to improve the dynamics of limb function recovery up to 6 months after surgery.
Orlyansky, V., & Golovakha, M. L. (2016). Guide to arthroscopy of the knee joint. Zaporozhye: Prosvita. [in Ukrainian]
Crawford, S. N., Waterman, M. B., & Lubowitz, J. H. (2013). Long-term failure of anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 29(9), 1566-1571. https://doi.org/10.1016/j.arthro.2013.04.014
Pinczewski, L. A., Lyman, J., Salmon, L. J., Russell, V. J., Roe, J., & Linklater, J. (2007). A 10-Year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft. The American Journal of Sports Medicine, 35(4), 564-574. https://doi.org/10.1177/0363546506296042
Clatworthy, M. G., Annear, P., Bulow, J., & Bartlett, R. J. (1999). Tunnel widening in anterior cruciate ligament reconstruction: A prospective evaluation of hamstring and patella tendon grafts. Knee Surgery, Sports Traumatology, Arthroscopy, 7(3), 138-145. https://doi.org/10.1007/s001670050138
Lui, P., Zhang, P., Chan, K., & Qin, L. (2010). Biology and augmentation of tendon-bone insertion repair. Journal of Orthopaedic Surgery and Research, 5(1), 59. https://doi.org/10.1186/1749-799x-5-59
Mayr, R., Smekal, V., Koidl, C., Coppola, C., Eichinger, M., Rudisch, A., Kranewitter, C., & Attal, R. (2019). ACL reconstruction with adjustable-length loop cortical Button fixation results in less tibial tunnel widening compared with interference screw fixation. Knee Surgery, Sports Traumatology, Arthroscopy, 28(4), 1036-1044. https://doi.org/10.1007/s00167-019-05642-9
Golovakha, M. L., Krasnoperov, S. N., Titarchuk, R. V., Zabelin, I. M., Tverdovskiy, A. O., & Orlyanskiy, V. (2017). Results of the reconstruction of the anterior cruciate ligament using the "all-inside" technology. Orthopedics, traumatology and prosthetics, 2(607), 84-91. https://doi.org/10.15674/0030-59872017284-91. [in Russian]
Calvo, R., Figueroa, D., Figueroa, F., Vaisman, A., Schmidt-Hebbel, A., Morales, N., & Izquierdo, G. (2017). Five-Strand hamstring autograft versus quadruple hamstring autograft with Graft diameters 8.0 millimeters or more in anterior cruciate ligament reconstruction: Clinical outcomes with a minimum 2-Year follow-up. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 33(5), 1007-1013. https://doi.org/10.1016/j.arthro.2016.10.028
Cavaignac, E., Marot, V., Faruch, M., Reina, N., Murgier, J., Accadbled, F., Berard, E., & Chiron, P. (2017). Hamstring Graft incorporation according to the length of the Graft inside tunnels. The American Journal of Sports Medicine, 46(2), 348-356. https://doi.org/10.1177/0363546517733472
Pouderoux, T., Muller, B., & Robert, H. (2019). Joint laxity and Graft compliance increase during the first year following ACL reconstruction with short hamstring tendon grafts. Knee Surgery, Sports Traumatology, Arthroscopy, 28(6), 1979-1988. https://doi.org/10.1007/s00167-019-05711-z
Kostretzis, L., Nakamura, K., Siebold, M., Fink, C., Smigielski, R., & Siebold, R. (2018). Flat anatomy of ACL and “ribbon like” ACL reconstruction. Journal of Research and Practice on the Musculoskeletal System, 02(04), 113-117. https://doi.org/10.22540/jrpms-02-113
Colombet, P., Saffarini, M., & Bouguennec, N. (2018). Clinical and functional outcomes of anterior cruciate ligament reconstruction at a minimum of 2 years using adjustable suspensory fixation in both the femur and tibia: A prospective study. Orthopaedic Journal of Sports Medicine, 6(10), 232596711880412. https://doi.org/10.1177/2325967118804128
Yoon, K. H., Kim, J. H., Kwon, Y. B., Kim, E. J., & Kim, S. (2019). Re-revision anterior cruciate ligament reconstruction showed more laxity than revision anterior cruciate ligament reconstruction at a minimum 2-year follow-up. Knee Surgery, Sports Traumatology, Arthroscopy, 28(6), 1909-1918. https://doi.org/10.1007/s00167-019-05653-6
Maslennikov, S. O,, Belinichev, I. F., Golovakha, M. L., Kucherenko, L. I,, & Mazur, I. A. (2018). Polypropylene medical grid. Patent 118166. Ukraine. [in Ukrainian]
Golovakha, M. L., & Maslennikov, S. O. (2020). Experimental study of the effect of implantation of polypropylene mesh in the defect of the capsule of the knee joint. Orthopedics, traumatology and prosthetics, 3(620), 11-18. https://doi.org/10.15674/0030-59872020311-18. [in Ukrainian]
Collins, N. J., Misra, D., Felson, D. T., Crossley, K. M., & Roos, E. M. (2011). Measures of knee function: International knee documentation committee (IKDC) subjective knee evaluation form, knee injury and osteoarthritis outcome score (KOOS), knee injury and osteoarthritis outcome score physical function short form (KOOS-PS), knee OU. Arthritis Care & Research, 63(S11), S208-S228. https://doi.org/10.1002/acr.20632
Copyright (c) 2021 Maxim Golovakha, Serhiy Maslennikov, Rostislav Titarchuk, Vadim Kirichenko, Alexandra Gritsenko
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available after 6 months from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.
Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.
The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).