Revision anterior cruciate ligament of knee reconstruction in case of anterolateral rotation knee instability in servicemen.

To identify the reasons for the high rate of revision operations after primary reconstruction of the anterior cruciate ligament analyzed the causes of recurrent anterolateral rotary instability of the knee in the military personnel. From 208 operations (2006-2011) performed according to transtibial method in 21 cases (10, 1%) recurrence of instability, requiring revision joint stabilization . From 484 reconstructions of the anterior cruciate ligament (2011-2015) according to transportal anatomical reconstruction technique revision performed in 11 cases (2.3%). It was established that the main cause of recurrent anterolateral rotary instability were non-anatomical bone channels conduction and violation of the physical exertion during the recovery period.

[An importance of early diagnosis in the course of knee joint instability treatment in military personnel].

The aim of the study was to determine the cause of the high frequency of meniscal tear coexisting rupture of the anterior cruciate ligament of the knee joint and to establish an optimal timing of surgical stabilization of the knee joint. Medical records of 476 patients who had surgery at the clinic of the Kirov Military Traumatology and Orthopedics of Military Medical Academy were studied. In 82 patients operation on the reconstruction of the anterior cruciate ligament was perormed in the early period after injury (up to 6 weeks), 347 patients were operated within a period exceeding 6 weeks. It was revealed that the soldiers who had the operation in the period after 6 weeks from the date of injury, secondary damage of meniscus and articular cartilage occured twice as much as in surgery performed during the acute phase. Thus, the reconstruction of the anterior cruciate ligament should be carried out in a specialized epartment in the early stages after injury, when not yet any secondary damage to the meniscus and articular cartilage.

[Modern approach to reconstruction of the anterior cruciate ligament in military personnel].

Analyzed data from annual reports of major trauma districts, chiefs of departments of hospitals and centers and reviewed the frequency and structure of surgical interventions on the knee, made in the last 5 years (2005-2010). In health care facilities the Defense Ministry. The frequency of the most typical injuries and diseases of the knee joint in different categories of servicemen and revealed the leading role the anterior cruciate ligament rupture. Analyzed stages of the evolution of anterior cruciate ligament reconstruction techniques in a specialized hospital department artrologicheskom Military Traumatology and Orthopedics MMA and a comparative characteristic of modern surgical approaches, providing anatomical and isometric position of the graft, as well as the minimal invasiveness of intervention with preservation of the sources of blood supply and potential revascularization autograft. Makes proposals for improving the organization of treatment of surgical pathology at the knee joint military operation and orthopedic trauma and military departments of medical institutions.