Analysis of the outcomes of different methods for graft fixation at the plasty of the anterior cruciate ligament
Keywords:knee joint, anterior crucial ligament, plasty, complications, implant
AbstractRestoration of the anterior crucial ligament (ACL) is one of the most frequently operations performing in orthopedic practice. But significant part of unsatisfactory results of treatment remains within 5–25 %. Objective: by analyzing the complications associated with the method of mount the ends of the graft to determine the optimal type of fixation, to study the long-term outcomes after plastic of ACL depending on the type of transplant and its fixation, to distinguish the most commonly used methods for graft fixation, and to analyze complications. Methods: there were assessed results of restoration of ACL in 329 patients (291 male, 196 female) operated for over 5 years ago (from 5 to 12 years). Among them there were no any high-level athletes. Patients were divided into groups according to their age: up to 20 years — 78, from 21 to 30 — 129, from 31 to 40 — 199, and over 40 year – 81 patient. All operations were performed by two experienced surgeons who used only one beam plasty of ACL. Femoral canal was formed from the anteromedial approach. Grafts made of semitendinosus and gracilis muscle tendons were used in 329 patients, and graft made of middle third of the patellar ligament with bone blocks – in 158 ones. Outcomes were assessed based on quantitative and qualitative analysis of complications after surgery, frequency of relapse, as well as according to the scale IKDC. Conclusions: The results of the ACL plasty are not dependent on the type of graft used and the method of its fixation. The most common complications were associated with graft failure relapses of instability — 8.5 %. There was marked a significant percentage of migration interference screws of polylactic acid (3,9 %) which led to their removal. Titanium implants «Endobutton» showed stable results and the lowest rate of complications.
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