Rotary Instability after Anterior Cruciate Ligament Reconstruction with Single BTB Tendon / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To analyze both the functional restoration and recovery of rotational and anterior-posterior stability after a single bundle ACL reconstruction using a BTB tendon. MATERIALS AND METHODS: A total of 52 patients were evaluated with an average follow up period of 32 months. A Lachman test, KT-2000 arthrometer, and Pivot shift test were performed to analyze the AP and rotational stability of the patients. The IKDC and Lysholm score was then used to evaluate the clinical results of the patients. The correlation between femoral tunnel angle and recovery of rotational stability was evaluated to determine the association between the two variables. This study also evaluated how the recovery of rotational stability affects the functional recovery of the patients. RESULTS: At the final follow up, the results indicated significant improvement according to the negative Lachman tests in 40 cases (76%), with an average of 2.92 mm anterior translation in the KT-2000 arthrometer and negative Pivot shift tests in 41 cases (79%)(p<0.05). The Lysholm and IKDC scores also showed significant improvement (p<0.05). Throughout the study, Group A was designated as those with <5 mm anterior translation and a negative Pivot shift test whereas Group B had positive test results. In Group A, the results showed 35 normal (85%), and 6 near normal (15%) cases in the IKDC score system, whereas Group B showed 2 normal (25%) and 5 near normal (62.5%) cases. Group A had an average of 89.3 in the Lysholm score system whereas Group B had a score of 60.5. On the knee tunnel view, Group A showed an average femoral tunnel angle of 49.2degrees, whereas Group B showed 63.5degrees. CONCLUSION: Decreasing the inclination of the BTB tendon using a transtibial femoral tunnel angle at either 10'30 or 1'30 will result in an excellent clinical outcome by achieving both anterior and rotational stability when operating a single bundle ACL reconstruction.