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1.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 1162-1168, 2023.
Artigo em Chinês | WPRIM | ID: wpr-1009040

RESUMO

OBJECTIVE@#To review the studies about the tibial-graft fixation methods on anterior cruciate ligament (ACL) reconstruction, in order to provide clinical reference.@*METHODS@#The literature about the tibial-graft fixation methods on ACL reconstruction at home and abroad was extensively reviewed, and the factors that affect the selection of fixation methods were summarized.@*RESULTS@#The knee flexion angle, graft tension, and graft fixation device are mainly considered when the tibial-graft was fixed on ACL reconstruction. At present, the graft is mainly fixed at 0°/30° of knee flexion. The study shows that the knee joint is more stable after fixed at 30°, while the incidence of knee extension limitation decrease after fixed at 0°. In terms of graft tension, a good effectiveness can be obtained when the tension level is close to 90 N or the knee flexion is 30° to recover the affected knee over-restrained 2 mm relative to the healthy knee. In terms of the graft device, the interference screw is still the most commonly used method of tibial-graft fixation, with the development of all-inside ACL reconstruction in recent years, the cortical button fixation may become the mainstream.@*CONCLUSION@#Arthroscopic reconstruction is the main treatment of ACL rupture at present. However, there is no optimal fixation method for the tibial-graft, the advantages and disadvantages of each fixation methods need to be further studied.


Assuntos
Humanos , Tíbia/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Articulação do Joelho/cirurgia , Lesões do Ligamento Cruzado Anterior/cirurgia , Parafusos Ósseos
2.
Journal of Medicine University of Santo Tomas ; (2): 270-276, 2019.
Artigo em Inglês | WPRIM | ID: wpr-974233

RESUMO

Background@# Anterior Cruciate Ligament (ACL) reconstruction is commonly performed to restore knee kinematics and halt the progression of osteoarthritis. A primary variable that could infl uence the outcome of ACL reconstruction is the tension applied to the graft at the time of fi xation. If the tension is too great, an abnormal compressive force could potentially develop across the tibiofemoral joint, hindering knee motion, and subjecting the articular surfaces to increased stress. If the tension in the graft is too low, the graft will not be effective in restoring normal kinematics. The Tegner Lysholm Knee Scale is a functional scoring for patients with ligamentous injuries. It is a patient-reported measure of knee function and is important for comprehensive assessment conditions in both the clinical and research context. Our objective was to compare which tension technique (15 lbs graft tension using a Mitek Tensioner™ vs maximal sustained two-hand technique) would yield better functional outcome at 6 months and 12 months postoperatively using the Tegner Lysholm Knee Scale. @*Methods @#Twenty-nine patients who underwent arthroscopic ACL reconstruction at the University of Santo Tomas Hospital Private Division were randomly divided equally into two groups (group A or group B). During tibial fi xation, group A would receive 15 lbs graft tension using a Mitek Tensioner and group B would receive graft tension using the maximal sustained two-handed pull technique. The patients underwent a standard rehabilitation protocol at an institution of their choice and a Lysholm Scoring Scale and Tegner activity scale were self-administered at 6 months and 12 months after the surgery in order to assess their functional outcome.@*Results @#The results showed that the functional outcome scores of group A were higher than group B. The yielded p-value was 0.10 (6 months), 0.07 (12 months) for group A and 0.27 (6 months), 0.46 (12 months) for group B. The results showed no suffi cient evidence of a signifi cant difference between the effects of arthroscopic ACL reconstruction with 15 lbs weight using a Mitek Tensioner (group A) and graft tension using the maximal sustained two-handed pull technique (group B) in the knee functional outcome of patients at 6 months and 12 months postoperatively@*Conclusion@#The functional outcome scores of patients who underwent ACL reconstruction using different graft tension did not show signifi cant results. Further re-evaluation of patients’ functional outcome score is necessary after 12 months postoperatively. The desired tensioning technique of the ACL surgeon would be at his/her convenience knowing beforehand the pros and cons of each technique.


Assuntos
Escore de Lysholm para Joelho , Tíbia
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