Value of reconstruct anterior cruciate ligament for remaining anteromedial or posterolateral bundle and ruptured fiber / 中国矫形外科杂志

ABSTRACT

[Objective] To evaluate the curative effect of anterior cruciate ligament(ACL)reconstruction for remaining anteromedial or posterolateral bundle and ruptured fiber.[Method]Among 89 cases of ACL rupture,there were 32 cases of sports injury,24 cases training injury,23 cases traffic accidents and 10 cases sprained in daily life.ACL ruptured at the notch of the femur in 24 cases,and at the intercondyle of the tibial in 28 cases.Thirty-two cases were reconstructed with quadri-bundle Hamstring tendon knot press-fit technique and 20 cases were reconstructed with quadriceps tendon press-fit technique with autogenetic patellar bone.ACL anteromedial bundle(AMB)ruptured in 14 cases and posterolateral bundle(PLB)ruptured in 23 cases.The intact bundle and the remnants of ACL were preserved.AMB and PLB were reconstructed with double-bundle Hamstring tendon knot press-fit technique in 37 cases.Absorbable interference screws were used at the tibial tunnel and sutured tendon was knotted across the tibial bone bridge.[Result]The average duration of follow-up were 25 months(14-37 months).Lysholm knee function score increased by 27.7 scores,from average 67.5 scores of pre-operation to average 95.2 scores at the end of the follow-up.Rulermetr examination tibial translation was 4 mm?2 mm in 72 cases and 6 mm?3 mm in 17 cases.Lachman test was negative in 79 case,weakly positive in 8 cases and positive in 2 cases.The function of the knees were improved and the stabilization was strengthened after operation.According to knee therapeutic effect evaluation criterion,76 cases were excellent and 13 cases were good.[Conclusion]To keep the remaining of anteromedial or posterolateral bundle and ruptured fiber for ACL reconstruction is beneficial for the graft revascularization or healing,and is helpful for the position sense or rehabilitation.