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Reconstructing anterior cruciate ligament injuries with autologous semitendinosus tendon using adjustable TightRope all inside |
BAI Xiaodong, WANG Yaoting, CHE Qi, XING Gengyan, and DING Hao |
Department of Orthopaedics, General Hospital of Chinese People Armed Police Force, Beijing 100039, China |
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Abstract Objective To study the feasibility and relative merits of reconstructing the anterior cruciate ligament injuries with autologous semitendinosus tendon using adjustable TightRope all inside, and its complications.Methods Forty-seven patients who suffered from anterior cruciate ligament injuries were referred to our department between July 2014 and July 2015. In 2-6 weeks, the broken ACL was reconstructed with autologous semitendinosus tendon using adjustable TightRope all inside. The medial collateral ligament damage was repaired or directly sutured with the gracilis tendon. The repaired semitendinosus graft was folded twice into portions of 6-6.5 cm by 7-9 mm, and was then linked with the adjustable TightRope device. The femoral and tibial socket preparation was made by retrograde drilling at the ACL print foot. The tendon graft was pulled into the bone tunnel through the anterior-medial port, the adjustable tight loop was locked step by step from two sides, and the titanium plate was fixed on the cortex of the bone. Those patients who were complicated with medial collateral ligament injuries were fixed with ipsolateral gracilis tendon. The anterior Drawer test, Lachman test, IKDC classification, Lysholm scores were calculated before and after surgery to evaluate the efficacy of reconstruction.Results These patients who had been treated surgically were followed up for 2 to 3 years, averaging 2.1 years. All their preoperative symptoms were effectively alleviated in the last follow-up, such as the pain of knees, swelling and limitation of range of motion. The anterior drawer test(-), the Lachman test(-), IKDC classification, and Lysholm scores after reconstruction were significantly increased (P<0.05). The range of motion of knees was 115°-130°. As for the knee IKDC score: 41 patients were rated normal(87.2%), 4 patients nearly normal(8.5%), and 2 patients abnormal(4.3%).The rate of normal and nearly normal scores was 95.7%. The knee function Lysholm score was (51.4±5.4) points before operation, and (92.2±4.6) points after operation, so the difference was of statistical significance(P<0.05).Conclusions Reconstructing the anterior cruciate ligament injuries with autologous semitendinosus tendon using adjustable TightRope all inside can recover the stability and function of knees, with remarkable short and medium-term efficacy.
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Received: 20 December 2017
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