[Reconstruction of anterior cruciate ligament with different grafts under arthroscope in 68 cases].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2007; 21(11):1163-6ZX
To study the clinical effect of anterior cruciate ligament (ACL) reconstruction with different grafts under arthroscope.
A retrospective analysis was done on 68 cases of ACL injury. ACL reconstruction with bone-patellar tendon-bone autograft and interface screw fixation were performed in 26 cases (group A) and quadruple semitendinosus tendon autograft and endobutton plate fixationin in 38 cases (group B). ACL reconstruction with bone-patellar tendon-bone allograft cryopreserved and interface screw fixation were performed in 4 cases (group C). There were 16 males and 10 females with an average age of 26.4 years (16-45 years) in group A, 24 males and 14 females with an average age of 24.6 years (13-48 years) in group B, and 3 males and 1 female (55-65 years) in group C. The left knee involved in 14 cases, 27 cases and 3 cases, and the right knee involved in 12 cases, 11 cases and 1 case in groups A, B and C, respectively. The disease courses were 1 week to 15 months (group A), 1 week to 16 months (group B) and 2 weeks to 28 months (group C). The intermediate myodynamic recovery, IKDC score and Lysholm score were compared among 3 groups.
All patients were followed 12-36 months (17.5 months in group A, 18.5 months in group B and 16.5 months in group C). No intra-articular infection, phlebothrombosis of leg, vascular injury and nerve injury occurred. Lysholm scores was increased from preoperative 65.3+/-4.8 to postoperative 95.1+/-4.3 in group A, from 68.4+/-5.6 to 93.0+/-5.9 in group B and from 60.3+/-6.7 to 92.2+/-4.3 (excellent in 3 cases and good in 1 case) in group C; the excellent and good rates were 88.5% (excellent in 18 cases, good in 5 cases and fair in 3 cases) in group A, 86.8% (excellent in 28 cases, good in 5 cases and fair in 5 cases) in group B, IKDC scores were 93.7+/-3.8 (group A), 95.7+/-4.7 (group B) and 94.8+/-3.6 (group C); the knee joint functions were normal in 19 cases (73.1%), in 30 cases (78.9%) and in 3 cases, were fair in 5 cases (19.2%), in 5 cases (13.2%) and in 1 cases in groups A, B and C respectively.
The transplantation of bone-patellar tendon-bone autograft , quadruple semitendinosus tendon autograft and bone-patellar tendon-bone allograft all can reconstruct and strengthen the stability of knee joint. Bone-patellar tendon-bone allograft is better selection for the ACL injury in elder and quadruple semitendinosus tendon autograft is suitable to adolescent patients with disrupted ACL.