The Effect of Augmentation with The Synthetic Polyester Ligament in The Tear of the Posterior Cruciate Ligament: A Preliminary Report

The purpose of this study is the present the short rerm result of arthroscopic reconstruction for PCL injury. Since January l990, authors have implanted the synthetic polyester ligament (ABC ligament, Surgicraft, U.K) into the substance of ruptured PCL proper under arthroscopic control. The follow up period ranged from 24 months to 61 months (average,35months). The main cause of injuries were traffic accidents in 38. Thirtyfive of patient were men and three were women, range in age from 18 to 70 years (average, 37 years). 18 were acute injury and operated at average 12 days after injury and 20 knee were chronic injury and operated at average 9 months after injury. There were 25 case that had combined ligament injuries (l2 ACL injury, ]0 MCL injury, 8 LCL injury elc). In 15 knees, the tear was in the mid substance area and in 13 it was near femoral attach site and in lO it was near tibial attach site. Postoperative result were evaluated by roentgenographic evaluation of posterior sagging, KT-20 (0 arthrometer and Lysholm knee score. Difference were improved from 12.5 mm (mean: pre.op) to 3.8m (mean: post.op) on posterior drawer test. Both knee showedminimal difference on KT-20N) study (2.l mm on 201b) at the time of follow up. The average Lysholm knee score were 84.7. By Clancy criteria, the result were exceflent 9 case (24%), good in 20 case (53%), fair in 7 case (18'Po) and failui e in 2 case (5%). On based of this study, arthroscopic augmentation with ABC ligament in PCL injury is very effective treatment but more longer follow-up and more case must he needed to accept this method.

The Effect of Augmentation with The Synthetic Polyester Ligament in Aculte Tear of The Anterior Cruciate Ligament Preliminary report / 대한정형외과학회잡지

The development of the arthroscopic surgery technique presented a great method in the reconstruction of anterior cruciate ligament. There were many debates about the timing of reconstruction in the acute anterior cruciate ligament injury. However, it was regarded true that primary reconstruction in the acute phase have higher complication rate of arthrofibrosis than in the chronic phase. Many authors recommended delay of reconstruction at least 3 weeks in acute tear of anterior cruciate ligament. In contrast, some surgeons have tried to suture the ruptured anterior cruciate ligament accompanied by 'over-the-top' augmentation with the hamstring tendon or the artificial ligament arthroscopically. Since Jan. 1992, the authors have implanted the synthetic polyester ligament(ABC ligament; Surgicraft, U.K.) into the substance of ruptured ligament proper and fixed at the 'over-the-top' position without any procedure for repair of the ruptured anterior cruciate ligament. Our indication for this surgery is only acute rupture of anterior cruciate ligament with good stump condition. We report the clinical results of 22 cases at 20.3 months follow-up(mean) preliminarily. l. On measurement of pre-operative and post-operative differences between the normal and the affected side by Telos stress X-ray study and KT-2000 arthrometer. Differences were markedly improved from 5.6mm(mean: pre-op) to 1.9mm(mean: post-op) on Telos stress X-ray study(on 15 Kp stress) and both knee showed minimal differences on KT-2000 study(2.2mm on 9Kp, 2.5mm on maximum stress) at the time of follow-up. 2. The average Lysholm score was 82. By Clancy criteria, the 20 cases(91%) showed good and excellent results. 3. Second look arthroscopy was available in three cases. In two cases, there were marked fibrous proliferation around the ligament. The stability felt good on probing. We could observe healing-like appearance of ruptured ACL with minimal fibrous tissue proliferation in one another case.