RESUMO
Objective:To investigate the effects of ligamen remnant preservation on knee joint function and proprioception recovery in patients with anterior cruciate ligament (ACL) injuries during ACL reconstruction under arthroscope.Methods:The clinical data of 266 patients with ACL injuries,who were treated in the 174th hospital of PLA from January 2010 to March 2016,were retrospectively analyzed.All the patients underwent ACL reconstruction under arthroscopy,among them,163 patients with remnant preservation were chosen as remnant preservation group;103 patients with completely clearing remnant preservation in the operation,as non remnant preservation group.All the patients were followed up for more than 12 months,and the knee function and proprioception recovery of the two groups were evaluated.Results:There were no significant differences in the knee ipsilateral Lysholm score,international knee documentation committee knee assessment scale (IKDC) score,passive activity detection threshold,passive angle regeneration test results between the two groups before operation,9 and 12 months after operation (P＞0.05).The Lysholm scores and IKDC scores of the two groups at each time point were significantly higher than those before operation,the passive activity detection threshold and passive angle regeneration test results were significantly lower than those before operation (P＜0.05).The Lysholm scores and IKDC scores in the remnant preservation group 3 and 6 months after operation were higher than those in the non remnant preservation group,the passive activity detection threshold and the passive angle regenerated test results were lower than the non remnant preservation group,the difference was statistically significant (P＜0.05).Conclusion:Remnant preservation in the ACL reconstruction under arthroscopy can accelerate the recovery of knee joint function and proprioception,and satisfactory clinical results are achieved,which is worth popularizing.
RESUMO
Objective To evaluate the risk of chondral injury during anterior cruciate ligament (ACL) reconstruction using a double cross-pin femoral fixation device via the anteromedial portal in Chinese cadavers. Methods Nine specimens of the knee (6 left ones and 3 right ones) were taken from 5 male and 4 female conservative cadavers of Chinese adult. The average age of the cadavers were 34.8 (26 to 45)years old. Femoral tunnel drilling and cross-pin guide insertion were performed using the Rigidfix Cross Pin device through the anteromedial portal. The ACL reconstructions were simulated at 3 entrance points of the cross-pin (0°, 45° and 90° relative to the horizontal plane) . The risks of chondral injury were statistically analyzed when the cross-pin entrance point was at the 3 different positions relative to the femoral chondral surface. Results The incidence of chondral injury was 100% when the Rigidfix cross-pin guide was at 90° relative to the horizontal plane. When the Rigidfix cross-pin guide was at 45° and 0° the incidences of chondral injury were 66. 7% and 22. 2% respectively. Conclusion Since there is always a risk of chondral injury when the Rigidfix cross-pin device is used to reconstruct ACL via the anteromedial portal, the anteromedial portal is not recommended for the ACL reconstruction using Rigidfix femoral fixation.