Analysis of the outcomes of different methods for graft fixation at the plasty of the anterior cruciate ligament

Authors

  • Maksim Golovakha
  • Weniamin Orljanski
  • Rostislav Tytarchuk
  • Igor Zasypko
  • Oleg Banit
  • Кarl Benedetto

DOI:

https://doi.org/10.15674/0030-59872015253-59

Keywords:

knee joint, anterior crucial ligament, plasty, complications, implant

Abstract

Restoration 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.

References

  1. Bolhovitin P. V. Recjstruction of cruciate ligaments in the system of knee instability surgery, dis ... kand.med.sciences: 14.01.21 / Institute of Spine and Joint Pathology. Ukraine Academy of Medical Sciences — Kharkiv, 2005.
  2. Boroday O. L. Arthroscopic double-bundle technique of anterior cruciate ligament reconstruction / O. L. Boroday, K. Pogrebnoy, V. Klapchuk // Bulletin of orthopedics, traumatology and prosthetics. — 2011. — № 4. — P. 35–40.
  3. Causes of recurrences of anterior-medial knee instability / S. S. Strafun, R. O. Sergienko, O. S. Strafun et al.// Orthopedics, Traumatology and Prosthetics.- 2010. — № 3. — P. 14–20.
  4. Predicting the results of treatment of patients with anteromedial instability of the knee / S. S. Strafun, R. O. Sergієnko, O. S. Strafun et al. // Orthopedics, Traumatology and Prosthetics. — 2012. — № 2. — Р. 64–67.
  5. Biomechanical analysis of stacked bioabsorbable screws in revision ACL reconstruction (SS-02) / L. LeClere, H. Baydoun, L. Guan [et al.] // Arthroscopy. — 2013. — Vol. 29 (6), suppl. — P. e1–e2, doi: http://dx.doi.org/10.1016/j.arthro.2013.03.009.
  6. Crawford S. N. Long-term failure of anterior cruciate ligament reconstruction / S. N. Crawford, B. R. Waterman, J. H. Lubowitz // Arthroscopy. — 2013. — Vol. 29 (9). — P. 1566–1571, doi: 10.1016/j.arthro.2013.04.014.
  7. Deep vein thrombosis after arthroscopic anterior cruciate ligament reconstruction: a prospective cohort study of 100 patients / M. C. Struijk-Mulder, H. B. Ettema, C. C. Verheyen, H. R. Buller // Arthroscopy. — 2013. — Vol. 29 (7). — P. 1211–1216, doi: 10.1016/j.arthro.2013.04.015.
  8. Incidence of post-operative ACL infections, graft choice makes a difference (SS-14) / G. Maletis, M. Inacio, S. Reynolds [et al.] // Arthroscopy. — 2013. — Vol. 29 (6), suppl. — P. e7, doi: http://dx.doi.org/10.1016/j.arthro.2013.03.021.
  9. Migration of «bioabsorbable» screws in ACL repair. How much do we know? A systematic review / H. Pereira, V. M. Correlo, J. Silva-Correia [et al.] // Knee Surg. Sports Traumatol. Arthrosc. — 2013. — Vol. 21 (4). — P. 986–994, doi: 10.1007/s00167-013-2414-2.
  10. Ramsingh V. Pre-tibial reaction to biointerference screw in anterior cruciate ligament reconstruction / V. Ramsingh, N. Prasad, M. Lewis // Knee. — 2014. — Vol. 21 (1). — P. 91–94, doi: 10.1016/j.knee.2013.07.011.
  11. Return to play following ACL injury in professional soccer players in the United Kingdom — a comparison of media prediction, public perception and actual findings / J. Neil, R. Saqib, H. Tucker [et al.] // Arthroscopy. — 2013. — Vol. 29 (10), suppl. — P. e111, doi: http://dx.doi.org/10.1016/j.arthro.2013.07.131.
  12. Siebold R. Anterior cruciate ligament reconstruction / R. Siebold, D. Dejour, S. Zaffagnini. — ESSKA–Springer, 2014. — 505 p.
  13. The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a multicenter orthopaedic outcomes network (MOON) cohort study / M. W. Mariscalco, D. C. Flanigan, J. Mitchell [et al.] // Arthroscopy. — 2013. — Vol. 29(12). — P. 1948–1953, doi: http://dx.doi.org/10.1016/j.arthro.2013.08.025.

How to Cite

Golovakha, M., Orljanski, W., Tytarchuk, R., Zasypko, I., Banit, O., & Benedetto К. (2015). Analysis of the outcomes of different methods for graft fixation at the plasty of the anterior cruciate ligament. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (2), 53–59. https://doi.org/10.15674/0030-59872015253-59

Issue

Section

ORIGINAL ARTICLES