Mid-term effects of arthroscopic anatomical reconstruction of double bundles of the anterior cruciate ligament / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the mid-term clinical outcomes of arthroscopic anatomical re-construction of double bundles of the anterior cruciate ligament ( ACL ) . Methods The clinical data of 78 patients diagnosed with ACL rupture from April 2012 to July 2014 were analyzed retrospectively. They were 60 males and 18 females, aged from 19 to 56 years ( mean, 26. 8 years ) . The time from injury to surgery ranged from one week to 23 months ( mean, 5. 8 months ) . All of them obtained positive results in anterior drawer test and Lachman test preoperatively. Their preoperative KT-1000 examinations showed an average side-to-side difference of 8. 29 ± 1. 81 mm in anterior laxity. They were all treated with arthroscopic anatomical recon-struction of double bundles of the anterior cruciate ligament using autologous hamstrings. The International Knee Documentation Committee ( IKDC ) and Lysholm scores were used to assess their knee function at the last follow-up. Results All the 78 patients were followed up for 34. 6 months on average ( range, from 25 to 56 months ) . At the last follow-up, the IKDC and Lysholm scores were significantly increased from preoper-ative 42. 6 ± 9. 5 and 44. 4 ± 8. 5 to postoperative 92. 9 ± 2. 8 and 94. 2 ± 3. 4, respectively ( P <0. 05 ) . The Lachman test was negative in 73 cases ( 93. 6％) and the pivot shift test was negative in 69 cases ( 88. 5％) . The KT-1000 examinations showed that the side-to-side difference in anterior laxity averaged 1. 47 ± 0. 68 mm, significantly improved from the preoperative values ( P <0. 05 ) . At their last follow-up, 29 patients underwent MRI scans which showed continuity of the anteromedial and posterolateral bundles of the anterior cruciate liga-ment. Conclusion The arthroscopic anatomical reconstruction of double bundles of the anterior cruciate ligament can restore the knee stability and achieve fine mid-term clinical outcomes.