[Application of arthroscopic RIGIDfix cross pins and Intrafix screw for posterior cruciate ligament reconstruction].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2008; 22(2):234-8ZX
To explore the short-term clinical effects on application of absorbable RIGIDfix cross pins and Intrafix screw for posterior cruciate ligament (PCL) reconstruction with autogenetic or xenogenic semitendinosus-plus-semimembranosus tendons under arthroscope.
From June 2005 to January 2007, 36 cases of PCL injuries (including 20 fresh injuries and 16 old ones) were treated. There were 21 males and 15 females, aged 15-51 years old, mean 30.4 years. There were 19 cases in the left side and 17 cases in the right side. Thirteen cases out of them complicated with medial collateral ligament injury; 9 cases complicated with lateral collateral ligament injury; 2 cases complicated with posterolateral structure injury; 11 cases complicated with medial meniscus injury; 10 cases complicated with lateral meniscus injury; 2 cases complicated with nerve and vascular injury. PCL reconstruction was accomplished by arthroscopy with autogenetic or xenogenic 4-strand semitendinosus-plus-semimembranosus tendons. RIGIDfix cross pins were used for tibial side fixation, and Intrafix was used for femoral side fixation. Lysholm scores, international knee documentation(IKDC) grading and Lachman experiment were used for evaluation before operation and in the follow up.
All the cases had been followed up for 6 to 26 months (average 10.4 months). IKDC grading showed that 3 patients (8.4 %) were graded as B, 12 patients (33.3%) as C, 21 patients (58.3%) as D before operation, while 9 patients (25 %) were graded as A, 21 patients (58.3%) as B, 6 patients (16.7%) as C after operation. Lysholm scores raised from 42.52 +/- 5.24 before operation to 91.24 +/- 5.68 after operation. Lachman experiment results showed that there were 5 cases (+), 20 cases (++) and 11 cases (+++) before operation, while there were 2 cases (+) and 34 cases (-) after operation. Each index was significant between before and after surgery (P < 0.05). After surgery, all the cases got good pain relief. Joint was stable, and motion range recovered. No pin and screw loosening was found. Only 4 cases suffered from effusion and synovitis after surgery, and they were recovered after conservative treatment.
The method of using RIGIDfix-Intrafix complexes under arthroscopy for PCL reconstruction is simple and the fixation is rigid. Early functional exercise after operation is possible.