Short-term Follow-up of Double Bundle ACL Reconstruction using Autogenous Hamstring Tendons Fixed with Ligament Plate(R) / 대한정형외과학회잡지

PURPOSE: We wanted to evaluate the clinical outcomes at a minimum 1-year following anatomic double bundle ACL reconstruction with using autogenous hamstring tendons fixed with Ligament Plate(R). MATERIALS AND METHODS: We evaluated a total of 50 patients. Semitendinosus tendon was used for the reconstruction of the anteromedial bundle and the gracilis tendon was used for the reconstruction of the posterolateral bundle. For femoral fixation, we used an anteromedial bundle that was suspended in Ligament Plate(R) and a posterolateral bundle linked with Mersilene tape(R). For tibial fixation, we used double post-tie. The average follow-up period was 16.5 months. We analyzed the clinical and radiographic results. RESULTS: At the last follow-up, the Lysholm score was 92.4+/-6.8 points. For the IKDC score, there were 35 cases of grade A, 14 cases of grade B and 1 case of grade C. The Lachman test was negative for 40 cases, it was grade 1 for 9 cases and it was grade 2 for 1 case and the pivot shift test was negative for 45 cases and it was grade 1 for 5 cases. The side-to-side differences with the KT-2000 and the anterior drawer radiogram were 1.3+/-1.6 mm and 1.3+/-1.3 mm, respectively. The femoral tunnel enlarged to 1.7+/-0.6 mm in the anteromedial aspect and 1.6+/-0.7 mm in the posterolateral aspect, and the tibial tunnel enlarged to 1.2+/-0.4 mm in the anteromedial aspect and 1.4+/-0.5 mm in the posterolateral aspect. CONCLUSION: Anatomic ACL reconstruction using autogenous hamstring tendons that are fixed with Ligament Plate(R) showed good clinical results due to the strong strength of early fixation and the anatomic restoration of the ACL.

A Short Term Follow-up of Anterior Cruciate Ligament Reconstruction using Hamstring Tendon Grafts fixed with Ligament Plate(R)

PURPOSE: To evaluate the clinical outcomes at a minimum of 1 year following the ACL reconstruction with use of Liga- ment Plate(R) which was invented for secure fixation of hamstring tendon graft into femoral tunnel. MATERIALS AND METHODS: Seventy-six patients who could followed up for minimum 12 months were treated with the ACL reconstruction fixed with Ligament Plate(R) using a four-stranded autologous hamstring tendon graft. For femoral fixation, we used Ligament Plate(R), and for tibial fixation, we used suture-post strengthened with cortical screw. Average follow up period was 18.6 months. Prior to surgery and at the follow-up examination, we evaluated the clinical results with Lachmann test, pivot shift test, Lysholm score and the difference of mid-thigh circumference, and KT 2000 arth- rometer was perfomed. For radiographic evaluation, we analyzed knee radiographs including anterior drawer radiographs and evaluated the degree of tunnel enlargement. RESULTS: Lysholm score improved from 61.6 points to 93.8 points. Lachman test revealed negative findings for sixty- three cases, and ten cases with grade 1 laxity and another three cases with grade 2 at last follow-up. Pivot shift test showed negative findings except six cases with grade 1 laxity at last follow-up. The results of KT 2000 arthrometer improved from 5.4mm difference compared with normal limb to 2.1mm respectively. The difference of mid-thigh circumference compared with normal limb showed 1.7cm. Radiographic analysis of anterior drawer view revealed 6.5 mm difference compared with normal limb preoperatively and 1.1 mm difference at last follow-up. Femoral and tibial tunnel enlarged to 2.7mm and 1.8 mm compared with immediate postoperative radiographs. CONCLUSION: ACL reconstruction using hamstring tendon grafts fixed with Ligament Plate(R) could provide sufficient strength of early fixation, and then could show good clinical results. However, long term follow-up was necessary.