Mahmood Karimi Mobarakeh, MD; Hooman Mohammadzadeh Eiedgahi, MD; Habibeh Ahmadipour, MD
Abstract
Background: Anterior cruciate ligament (ACL) is one of the major stabilizing ligaments of the knee. ACL reconstruction usually has high success rate. The choice of graft in ACL reconstruction has been a source of controversy. This study compares the outcome of two commonly used grafts.
Methods: Seventy ...
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Background: Anterior cruciate ligament (ACL) is one of the major stabilizing ligaments of the knee. ACL reconstruction usually has high success rate. The choice of graft in ACL reconstruction has been a source of controversy. This study compares the outcome of two commonly used grafts.
Methods: Seventy patients with ACL tear among the cases referring to training hospitals of Kerman, Iran from 2013 to 2015 were studied. The patients underwent reconstruction, using, randomly, either the "four-fiber semitendinosus autograft" or tibias abterior allograft". The Lysholm, IKDC, KOOS and SF36 scores were evaluated for comparing clinical stability examination, laxity, subjective satisfaction, and return to work before and after surgery.
Results: The two groups were the same in term of age, range of motion, knee flexion, IKDC, KOOS, Lysholm scores as well as SF36. The ligament laxity did not show a significant difference either. The operative time was significantly different between two groups (p < /em><.001).
Conclusions: ACL reconstruction with tibias anterior allograft has similar clinical, functional and stability results as semitendinosous autograft in a short time follow-up; although the operation time was shorter in allograft group.
Saeid Tabatabaei, MD; Miremad Miremarati, MD
Abstract
Background: Rupture of the anterior cruciate ligament (ACL) is the most common knee injury during sport activities. The purpose of this study was to investigate the results of ACL reconstruction using middle 1/3 of the autologous patellar ligament by miniarthrotomy approach in young patients.
Methods: ...
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Background: Rupture of the anterior cruciate ligament (ACL) is the most common knee injury during sport activities. The purpose of this study was to investigate the results of ACL reconstruction using middle 1/3 of the autologous patellar ligament by miniarthrotomy approach in young patients.
Methods: In a descriptive study, 57 patients (55 male, 2 female) at age of 20 to 45 years old, who were referred with ACL rupture and treated with ACL reconstruction using autograft bone-patellar-bone during a 2-year period in a training hospital in Ahvaz, Iran, were studied. The clinical results were investigated with an 11.7 months (7-28 months) follow-up, using Lysholm Knee Score, and physical re-evaluation.
Results: In 33 cases, right knee and in 24 left knee was affected. Eighty-six percent of the patients had no limitation in knee motion after surgery, and 82 percent had no knee instability. Ninety-six percent of the patients could return to the pre-injury sport activity. The mean Lysholm knee score was 83.63 (69-93).
Conclusions: Reconstruction of the anterior cruciate ligament using autograft bone-patellar-tendon with miniarthrotomy has clinically acceptable results.
Fardin Mirzatolouei, MD; Hossein Alizadeh, MD
Abstract
Background: Wrong placement of the ACL transplant especially in femoral site can result in early graft failure. Anatomical placement of the femoral tunnel results in restoration of knee kinematics closer to those of the intact knee. This placement could be performed by either using “aimer device” ...
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Background: Wrong placement of the ACL transplant especially in femoral site can result in early graft failure. Anatomical placement of the femoral tunnel results in restoration of knee kinematics closer to those of the intact knee. This placement could be performed by either using “aimer device” or with “free hand” methods. We compare the geometric position of femoral canal created by these two techniques.
Methods: In a prospective study, 22 patients were devided into two groups (11 patients) and operated by using femoral aimer instrument and “Free hand” techniques. Intra-operative fluoroscopy for femoral guide pin position was performed to determine the guide pin position. Vertical and horizontal coordinates of guide pins in both groups were outlined and compared with standard anatomical point of guide pins.
Results: in “aimer” group the coordinates of the guide pin location was 41.33% vertically and 33.49% horizontally and the difference with anatomic location in both vertical (p < /em>=.03) and horizontal (p < /em>=.02) vectors was significant. The coordinates for the location of the guide pin in the “free hand” group were 35.33% and 33.07% respectively and the difference between anatomical location and guide pin width was significant (p < /em>=.04), and in this group, difference in the height was observed. The sum errors in width and height plane in “aimer” and “free hand” groups were 13.82 and 7.4 respectively.
Conclusions: Anatomic positioning of guide pin is possible through both free hand and instrument techniques. The percentage of error in instrument technique is more than free hand method.
Amir Mohammad Navali, MD; Mehraban Mehraeen, MD
Abstract
Background: Anterior cruciate ligament (ACL) is a critical element in the biomechanics of knee joint stability. ACL tear increases the risk of meniscal and articular cartilage injury. This study evaluated the occurrence of meniscal and chondral injuries and the results of ACL reconstruction with more ...
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Background: Anterior cruciate ligament (ACL) is a critical element in the biomechanics of knee joint stability. ACL tear increases the risk of meniscal and articular cartilage injury. This study evaluated the occurrence of meniscal and chondral injuries and the results of ACL reconstruction with more than 7 years delay in ACL reconstruction.
Methods: In a cross sectional study, 43 patients (39 men, 4 women) at mean age of 38 years, who underwent ACL reconstruction with a delay of more than 7 years, were studied. The Lysholm, IKDC, Tenger and KOOS scores were evaluated before surgery and at the last follow up. The observed meniscal or chondral lesions were collected from the patients’ arthroscopic records. The mean follow-up was 34 months.
Results: The mean time interval between primary trauma and ACL reconstruction surgery was 121 months. A total of 39 cases (90/7%) had chondral lesions which include 20 cases of grade I/II and 19 cases of grade III/IV lesions. In 35 patients (81.4%) meniscal tear was observed. Only two cases (4.6%) had isolated ACL tear. A statistically significant improvement in IKDC, Lysholm, KOOS, and Tegner score was observed following surgical treatment (p < /em><.001).
Conclusions: Longstanding ACL tear leads to increase the occurrence of meniscal and cartilage injuries. Delayed ACL reconstruction in this group of patients can improve IKDC, Lysholm and KOOS knee scores and Tegner activity level.
Sohrab Keyhani, MD; Arash Sherafat Vaziri, MD; Mohammad Hossein Nabian, MD
Abstract
Background: The objective of this study was to evaluate the results of repairing root and para-root radial tears of lateral meniscus during cruciate ligament reconstruction. Methods: In a retrospective study, from the 60 patients who had been treated for root or para-root injury of the lateral meniscus ...
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Background: The objective of this study was to evaluate the results of repairing root and para-root radial tears of lateral meniscus during cruciate ligament reconstruction. Methods: In a retrospective study, from the 60 patients who had been treated for root or para-root injury of the lateral meniscus from 2007 to 2011 in 3 centers in Tehran-Iran. Only 40 patients were studied with an average followe-up of 32.4 months (24-48 months). The patients were evaluated by International Knee Documentation Committee (IKDC), Lysholm and Tegner scoring systems subjectively, and by objective Lachman and McMurray tests. Results: 34 patients were operated for ACL reconstruction and 6 for ACL and PCL reconstruction and lateral meniscus tears were repaired simultaneously. On the final follow-up, all the patients had firm end-points tested by Lachman. None reported popping or clicking. The mean IKDC score was 75.25 (range: 54-92), the mean Lysholm score was 94.4 (excellent) in 22 patients and the mean Tegner score was 7.15. From the 16 patients who were professional soccer players, 14 were still playing competitively at the time of follow-up. Conclusions: The midterm results of lateral meniscus repair - at root or para-root level - in association with ACL or / and PCL reconstruction, are acceptable.
Mohammad Mehdi Sarzaeem, MD; Mohammad Razi, MD; Farideh Najafi, MD; Mohammad Amin Najafi
Abstract
Background: The gold standard in ACL reconstructions has been the bone–patellar tendon–bone autograftfixed with interference screws. This prospective study, aimed to compare two method of fixation for BPTB grafts: press fit fixation vs. interference screw, over a 12 months follow-up interval.Methods: ...
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Background: The gold standard in ACL reconstructions has been the bone–patellar tendon–bone autograftfixed with interference screws. This prospective study, aimed to compare two method of fixation for BPTB grafts: press fit fixation vs. interference screw, over a 12 months follow-up interval.Methods: In a randomized clinical trial study, 158 patients with an average age of 29.8 years were treated for torn ACL with BPTB autograft in a teaching hospital in Tehran, Iran. In 82 patients press fit fixation technique, and in 76 cases an interference-screw was used. At the time of final follow-up, 71 patients in press-fit group and 65 patients in interference-screw group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications.Results: In the final follow-up, 59 cases in interference screw and 55 in press-fit screw group had good-to-excellent IKDC score (p < /em>≥.05). The mean laxity assessed improved to 2.7 mm and 2.5 mm in press-fit and screw group, respectively. Regarding Lachman and pivot shift tests, there was a statistically significant improvement in the integrity of the ACL in both groups, with no significant difference (p < /em>≥.05).Conclusions: the press-fit technique is an efficient procedure. Its outcome was comparable with the interference screw group. Furthermore it has unlimited bone-to-bone healing, no need for removal of hardware, ease for revision and cost effectiveness.
Abstract
Background: The choice of graft for anterior cruciate ligament ACL reconstruction remains controversial. This study aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis grafts for ACL reconstruction over a 3 year follow-up interval.Methods: ...
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Background: The choice of graft for anterior cruciate ligament ACL reconstruction remains controversial. This study aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis grafts for ACL reconstruction over a 3 year follow-up interval.Methods: In a randomized clinical trial study, 71 patients with an average age of 29 years were treated for ACL between 2008 and 2009. Forty six patients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. In the last year of follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications.Results: At 36 month follow-up, 34 patients in BPTB and and 28 in ST group, had good-to-excellent IKDC score (p < /em>≥.05).Lachman test was graded normal, for 23 while patients in BPTB and / in ST group, (p < /em>=.043) normal pivot-shift test was present in, 29 and 15 patients, respectively (p < /em>=.038). There was no significant difference in terms of thigh circumference knee effusion, range of motion or pain. The complications rate was also similar.Conclusions: These results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level, and knee function.
Jalil Zare'e, MD; Jalil Zare'e, MD; Arefeh Hedayati, MD; Mohammad Reza Hedayati, MD; Mahmoud Vakili, MD; Farshad Safdari, MSc
Abstract
Background: There is a great debate about the proper autograft for arthroscopic anterior cruciate ligament reconstruction (ACLR). In current study, we compared the clinical and functional outcomes of ACLR using either medial hamstring (MH) tendon or patellar tendon (PT).
Methods: Eighty ...
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Background: There is a great debate about the proper autograft for arthroscopic anterior cruciate ligament reconstruction (ACLR). In current study, we compared the clinical and functional outcomes of ACLR using either medial hamstring (MH) tendon or patellar tendon (PT).
Methods: Eighty eight patients with anterior cruciate ligament (ACL) injury contributed to a retrospective study. The study was done in a teaching hospital in Yazd, Iran. Patients were divided into two groups based on the type of autograft used for ACLR: MD (48 patients) and PT (40 patients). In a follow-up of 18.5±2.2 months in MH and 19.3±2.9 months in PT group, the pain was analized using visual analogue scale (VAS) and the range of knee flexion was measured. The result of the surgery was assessed utilizing Tegner-Lysholm score, KOOS (Knee injury and osteoarthritis outcomes) and return to the previous activity.
Results: The two groups were the same in term of range of knee flexion, KOOS and Tegner-Lysholm score. The VAS averaged .9±.3 in MH and 1.15±.5 in PT groups, with no significant difference. Return to previous activity was seen in 80% of PT group and 85.4% of MH group.
Conclusions: ACLR using either MH or PT autograft, is effective in short-term, and is associated with satisfactory clinical and functional outcomes.
Fardin Mirzatolooei; Michael Tafkiki Alamdari; Hamidreza Khalkhali
Abstract
Background: The use of platelet-rich plasma (PRP) as an adjuvant to tissue repair is gaining favour in orthopaedic surgery. Tunnel widening after anterior cruciate ligament (ACL) reconstruction is a recognised phenomenon that could compromise revision surgery. The purpose of this study was to determine ...
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Background: The use of platelet-rich plasma (PRP) as an adjuvant to tissue repair is gaining favour in orthopaedic surgery. Tunnel widening after anterior cruciate ligament (ACL) reconstruction is a recognised phenomenon that could compromise revision surgery. The purpose of this study was to determine whether PRP might prevent tunnel widening in ACL reconstruction. Methods: In a randomized clinical study, during one year patients undergoing ACL reconstruction using a hamstring graft were randomly allocated either to have PRP introduced into the tunnels (group 1) peri-operatively or not (group 2). Each group comprised 25 patients. CT scanning of the knees was carried out on the day after surgery and at three months post-operatively and the width of the tunnels was measured. Patients were also evaluated clinically at three months, when laxity was also measured. Results: Three months post-operatively, all patients were pain-free with stable knees, a negative Lachman test and a good range of movement. Arthrometric results had improved significantly in both groups (p < /i>≥.05). Conclusions: We conclude that PRP has no significant effect in preventing tunnel widening after ACL reconstruction.
Azin Zargham; Karim Leilnahari; Soheil Mehdipoor; Elnaz Nouri; Sohrab Keihani
Abstract
Background: Anterior cruciate ligament (ACL) tear is a common injury in sports. Different technigues for reconstruction of this ligament have been suggested. This paper compares the knee kinematics between "single bundle" and "double bundle" ACL reconstruction with hamstring tendon in a computerized ...
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Background: Anterior cruciate ligament (ACL) tear is a common injury in sports. Different technigues for reconstruction of this ligament have been suggested. This paper compares the knee kinematics between "single bundle" and "double bundle" ACL reconstruction with hamstring tendon in a computerized knee model. Methods: A computer-knee modle was constructed. Then "single bundle" and "double bundle" ACL reconstruction was performed. The knee stability and ligament tension were tested in 3 different settings: 1) At 30° knee flexion under isolated postero-anterior load, valgus and rotational torque was applied, 2) In weight-bearing flexion range (from extension to 70° of flexion) an anterior load of 134 Newton was applied, 3) Knee model was loaded by a non-contact pivot farce to produce ACL rupture. Results: The results showed no significant difference between "single bundle" and "double bundle" under isolated loading. The second and third model, however, showed 4 times greater tension on the ligament in "single bundle". The "single bundle" in the second technique of testing (weight bearing) showed at most 7 mm more displacement compared with "double bundle". In the third testing technique "double bundle" was stronger than "single bundle" in valgus torque resistance. The internal rotation stability was also more in "double bundle". Conclusion: Functional stability of knee model of ACL reconstruction with a "double bundle" graft is superior to a "single bundle" graft.
Seyyed Morteza Kazemi; Siyavosh Hemmati Eslamlou; Arash Maleki; Reza Zandi; Mohammad Ali Jalili; Keyghobad Ashoori; Farshad Safdari
Abstract
Background: The role of increased posterior tibial slope in rupture of the anterior cruciate ligament (ACL) is controversial. The purpose of current study was to determine the effect of posterior slope on the ACL injury. Methods: In a case control study, 61 consecutive cases with ACL injury, who were ...
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Background: The role of increased posterior tibial slope in rupture of the anterior cruciate ligament (ACL) is controversial. The purpose of current study was to determine the effect of posterior slope on the ACL injury. Methods: In a case control study, 61 consecutive cases with ACL injury, who were candidates for reconstruction, were compared with 61 persons with normal knees who were matched for age and sex, over a 2-year period at a teaching hospital in Tehran, Iran. The posterior tibial slope angles were measured on true lateral radiographs on all the cases. The measurement variations were analyzed between the two groups. Results: The mean posterior tibial slope was 9.4±1.8 degrees in controls and 12.3±4.4 in patients with ruptured ACL (p < .001). The incidence of tibial slope greater than 10 degrees in patients with ruptured ACL was 3.1 times greater than that of the controls. Conclusion: This study suggests that increased tibial slope angle may contribute to increased risk for ACL rupture.
Mohammad Reza Farahanchi Baradaran; Seyyed Morteza Kazemi; Seyyed Mehdi Hosseini Khameneh; Seyyed Mohammad Jazaeri; Firooz Madadi; Keyghobad Ashoori; Katayoon Kazemi; Reza Zandi; Farshad Safdari
Abstract
Background: Arthroscopic reconstruction of the anterior cruciate ligament is one the most common orthopaedic surgeries. There are scattered reports about the beneficial effects of post operative cox2-inhibitors administration on knee motion. The purpose of the current study was to determine the effects ...
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Background: Arthroscopic reconstruction of the anterior cruciate ligament is one the most common orthopaedic surgeries. There are scattered reports about the beneficial effects of post operative cox2-inhibitors administration on knee motion. The purpose of the current study was to determine the effects of cox-2 inhibitor on pain, range of motion and weight bearing after arthroscopic reconstruction of the anterior cruciate ligament. Methods: In this clinical trial, 70 patients who underwent arthroscopic reconstruction of the anterior cruciate ligament were assessed in a teaching hospital in Tehran-Iran. They were divided into case (cox2-inhibitor) and control groups. Postoperatively, pain, inflammation, range of motion and ability for full weight bearing were measured. Results: The mean of pain at the postoperative day 3 was 5.3±1.04 (visual analogs scale of 0 to 10) in the control and 3.3±0.71 in the case group. 29.6% of the patients in the control group and 82.8% in the case group were able to flex the knee more than 90° one week postoperatively. In the first week, all of the patients in the case group and only 28.6% in the control group were able to walk without any assistive device. The post operative knee circumstances were 2.73±0.59 and l.61±0.92 centimeters smaller respectively in case and control groups. Statistical analysis showed significant differences between the two groups, in the above measurements. Conclusion: Cox-2 inhibitor is effective in relieving pain reducing the inflammation, and accelerating the rehabilitation program after arthroscopic reconstruction of the anterior cruciate ligament.
Ali Akbar Esmailijah, MD; Seyyed Mohammad Jazaeri, MD; Seyyed Mehdi Hosseini Khameneh, MD; Firooz Madadi, MD; Sohrab Keihani, MD; Keyghobad Ashoori, MD; Pooran Hakimi, MD; Reza Zandi, MD; Mehdi Rahimi, MD; Farshad Safdari, MSc
Abstract
Background: Incorrect tunneling is one of the concerns in arthroscopic anterior cruciate ligament reconstruction. The purpose of the current study was to determine the incidence of the correct femoral and tibial tunnel positions.Materials: In a cross-sectional study, the CT image positions of the tibial ...
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Background: Incorrect tunneling is one of the concerns in arthroscopic anterior cruciate ligament reconstruction. The purpose of the current study was to determine the incidence of the correct femoral and tibial tunnel positions.Materials: In a cross-sectional study, the CT image positions of the tibial and femoral tunnels in 40 patients that had undergone arthroscopic ACL reconstruction using single-bundle hamstring tendon were studied. The parameters that were evaluated were: tibial tunnel position in axial and sagittal cuts, femoral tunnel position in axial cut, appropriate thickness of the posterior cortex at the intercondylar notch, and femoral exit point.Results: The correct position of the tibial and femoral tunnels, appropriate thickness of the posterior cortex at the intercondylar notch, and the correct position of the "femoral exit point" were respectively recognized in 60%, 52.5%, 70%, and 67.5%. In total, the correct position of the femoral and tibial tunnels was seen on 37.5% of patients. These parameters were compared with known standard anatomic positions.Conclusion: Although the incidence of correct tibial and femoral tunnel positioning in ACL reconstruction, when viewed separately, was acceptable when looked at as one tunnel was not satisfactory. More precise attention and expertise seem necessary for the operating orthopaedic surgeons.
Firooz Madadi, MD; Jaafar Tavakolian, MD; Arash Maleki, MD; Mehdi Rahimi, MD; Reza Zandi, MD; Mohammad Reza Bigdeli, MD
Abstract
Background: The anterior cruciate ligament is the primary structure that controls anterior displacement in the unloaded knee. Anterior cruciate ligament reconstruction may return normal functions of the knee. The aim of the present study was to compare three different femoral fixation techniques in anterior ...
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Background: The anterior cruciate ligament is the primary structure that controls anterior displacement in the unloaded knee. Anterior cruciate ligament reconstruction may return normal functions of the knee. The aim of the present study was to compare three different femoral fixation techniques in anterior cruciate ligament reconstruction.Methods: In a clinical trial study, 120 patients that were candidates for ACL reconstraution were randomly divided into 3 groups of 40 individuals. The femoral fixations were by the three methods of "Aperfix", "Rigidfix" or "Endobutton". The cases were re-examined 12 months after surgery and evaluated by Lysholm score as well as with KT-1000 machine. The results were compered together for the three above methods.Results: The Lysholm score showed improvement from pre-operative values in all three techniques: From 63.21±18.59 to 90.64±9.47 in "Endobutton" group, from 65.72±18.74 to 96.22±5.35 in "Aperfix" and from 69.21±17.45 to 90.64±9.47 in the "Rigifix" group. There were 6 failures in "Endobutton", 4 in "Rigidfix" and one in "Aperfix" group. The anterior displacement tibia was 3.96±1.58 millimeters in "Endobutton", 4.28±1.48 in "Rigidfix", and 4.03±1.79 millimeters in "Aperfix" group. There was no significant difference in the operating time in the 3 groups.Conclusion: Regarding the instant stability of the graft, the "Aperfix" method seemed stranger. Further investigations with larger number of cases and longer duration of follow up are recommended.
Fardin Mirzatolouei, MD; Mahnaz Ahmadifar, MD; Ahmad Reza Afshar, MD
Abstract
Background: Anatomic attainment of anterior cruciate ligament (ACL) to the femoral notch is not quite easily visible due to the synovial covering. There is no information on femoral attachment of ACL in Iranian population. Our aim is to study the topography of this ligament in a group of fresh cadavers.Methods: ...
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Background: Anatomic attainment of anterior cruciate ligament (ACL) to the femoral notch is not quite easily visible due to the synovial covering. There is no information on femoral attachment of ACL in Iranian population. Our aim is to study the topography of this ligament in a group of fresh cadavers.Methods: Ten fresh cadavers that were all younger than 50 years of age and had no evidence of trauma to or surgery on their knees were chosen for the study. The knees were dissected and the presence or absence of double ACL strands was evaluated. The ligaments were then taken off the femur and insertion sites were carefully studied and documented by digital photography. The distances were measured using a ruler.Results: In 90º flexion with distal traction onto the ACL, the ligament was like a twisted interwoven cord. The twist would decrease by releasing the traction or decreasing the knee bent. Two separate bundles (antero-medial and postero-lateral) were identified in 7 cadavers. In the 3 remaining ones in gross inspection and without dissection one could not recognize two separate bundles in the ACL’s. The femoral attachment sites were curve, triangle or oblong. In cross-sectional, however, they were oblong.Conclusion: Anterior cruciate ligament could have both variable femoral attachment sites and also different bundle patterns in different individuals.
Firooz Madadi, MD; Mohammad Reza Abbassian, MD; Fooad Rahimi, MD; Farivar Abdollahzadeh Lahiji, MD; Armin Aalami Harandi, MD; Farzam Farahmand; Tahereh Yazdanyar; Firozeh Madadi; Reza Sadeghian
Abstract
Background: Several different methods for fixation of grafts in anterior cruciate ligament (ACL) reconstruction have been used. The purpose of present study is to compare two techniques of tibial fixation in hamstring quadruple graft reconstruction. Methods: In a randomized clinical trial study, 46 ...
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Background: Several different methods for fixation of grafts in anterior cruciate ligament (ACL) reconstruction have been used. The purpose of present study is to compare two techniques of tibial fixation in hamstring quadruple graft reconstruction. Methods: In a randomized clinical trial study, 46 cases of isolated tears were reconstructed using hamstring grafts. In 24 cases the tibial fixation sites were fixed with interference screw, and in 22 patients the remnant end of graft at tibia was passed through a bony tunnel and fixed with suture to the bone. The cases were all assessed with a mean follow-up of one year with “Cincinnati knee ligament rating scale” and “KT-2000” examination.Results: The score in 22 “target group” cases was 8, and in 24 “control group” was 9. In “KT-2000” examination, 11 patients of double fixation were excellent and 11 good. In control group 4 cases had excellent and 20 good results (p < /em>=0.01).Conclusions: Double tibial fixation for ACL reconstruction with Hamstring tendon graft has a better outcome on “Symptom” evaluation and “KT-2000” instrument compared to single tibial-site fixation.
Fardin Mirzatolouei, MD; Ahmadreza Afshar, MD
Abstract
Background: We evaluated the short term results of reconstruction of anterior cruciate ligament ruptures using a four strand hamstring autograft and cross pin femoral fixation.Methods: In a cross-sectional study 24 patients (1 female, 23 males) with mean age of 25 years (20-34) with chronic ACL ruptures ...
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Background: We evaluated the short term results of reconstruction of anterior cruciate ligament ruptures using a four strand hamstring autograft and cross pin femoral fixation.Methods: In a cross-sectional study 24 patients (1 female, 23 males) with mean age of 25 years (20-34) with chronic ACL ruptures were studied in a hospital in Urmia. The patients were treated with a four-strand hamstring autograft, cross pin femoral fixation (transfix) and an interference srcrew on the tibial side. Eight patients received simultaneous treatment for meniscal pathology. Final evaluation was performed 9 months after surgery, using the Lysholm and tegner scales, radiographs and a simple arthrometer.Results: The Lysholm score was good or excellent in 22 petients, fair in one and poor in one patient. Mean Lysholm score was 85.9. Tegner activity scores demonstrated that 16 patients had moved at least one level up, and the remaining cases stayed at their pre-operative level. Arthrometer showed a significant decrease in anterior tibial translation. Two patients developed septic arthritis one of whom required graft, pin and screw removal. Because of graft harvest failure, hamstring graft was taken from the contra lateral side in 2 patients.Conclusions: Reconstruction of ACL using four-strand hamstring tendons and cross pin femoral fixation results in considerably high success rate in short term. Infection and graft harvest failure are the major complications.
