Anatomik Ön Çapraz Bağ Rekonstrüksiyonun Femoral Tünel Oblisitesi İle İlişkisinin Klinik Olarak Değerlendirilmesi

Year 2019, Volume: 9 Issue: 3, 115 - 121, 30.09.2019

Ozan Turhal , Zekeriya Okan Karaduman , Yalçın Turhan , Cemal Güler Şengül Cangür , Mehmet Arıcan

https://doi.org/10.33631/duzcesbed.577371

Abstract

Amaç: Artroskopik ön
çapraz bağ (ÖÇB) rekonstrüksiyonlarında hamstring tendon grefti, patellar
tendon grefti, allogreft gibi çeşitli tendon greftleri kullanılmaktadır.
Çalışmamızda, Otojen Hamstring Tendonlar kullanılarak Anatomik Ön Çapraz Bağ
Rekonstrüksiyonu uygulanan hastalarda femoral tünel oblisitesinin sonuçlarını
güncel literatür eşliğinde değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Ocak 2013 –
Haziran 2016 tarihleri arasında ön çapraz bağ rüptürü nedeniyle kliniğimizde
cerrahi olarak tedavi edilen hastalar telefonla aranarak hastaneye davet
edildi. Bunlar içerisinden fizik muayeneleri, grafi kontrolleri ve ölçümleri
yapılan 64 hasta çalışmaya dâhil edildi.

Bulgular: Hastalarımızın
55’i erkek, 9’u bayandı. Hastaların yaş ortalaması 29.3±8.12 (14-47) idi.
Ortalama takip süremiz 14.47±7.44 (6-36) aydır. Kontrol Lysholm ve Tegner skoru
ameliyat öncesi değerlerle karşılaştırıldığında istatistiksel açıdan ileri
derecede anlamlı farklılıklar bulundu (p<0.001). International Knee
Documentation Committee (IKDC) diz bağları değerlendirme sistemine göre
ameliyat öncesi 3 hasta (%4.7) B, 18 hasta (%28.12) C ve 43 hasta (%67.18) D
olarak saptandı. Ameliyat sonrası yapılan son kontrol muayenesinde 41 hasta
(%64.06) A, 21 hasta (%32.81) B ve 2 hasta (%3.12) C grubuna dâhil edildi.
Ortalama femur tüneli oblisitesi 41.2±7.2° bulundu.

Sonuç: Ön çapraz
bağ’ın rotasyonel stabilitesine oblik femoral tünel yerleşiminin daha fazla
yarar sağladığı düşünülmektedir. Biz bu çalışmamızın sonucunda ön çapraz bağın
otojen hamstring tendon grefti kullanarak anatomik teknikle uygulanmasının
femoral tünel oblisite artışının fonksiyonel sonuca katkısının daha yararlı
olduğu kanaatindeyiz.  

Keywords

Anterior cruciate ligament reconstruction, rüptür, artroskopi

Clinical Evaluation of the Relationship of Anatomical Anterior Cruciate Ligament Reconstruction with Femoral Tunnel Obliquity

Abstract

Aim: Various tendon
grafts such as hamstring tendon graft, patellar tendon graft, allograft are
used in arthroscopic anterior cruciate ligament (ACL) reconstructions. In our
study, we aimed to evaluate in the light of the updated literature, femoral
tunnel obliquity results of anterior cruciate ligament (ACL) reconstruction
using autogenous hamstring tendon graft.

Material and Methods: Between January 2013 and June 2016, the surgically treated patients in
our clinic who had anterior cruciate ligament (ACL) rupture were called and
invited to hospital by telephone. 64 patients whose physical examinations,
radiographs and measurements were completed have been included in the study.

Results: 55 of
our patients were male and 9 were female. The mean age of the patients was
29.3±8.12 (14-47) years. Total follow-up time was 14.47±7.44 (6-36) months.
There were statistically significant difference between control and follow-up
Lysholm and Tegner activity scores (p<0.001). According to the International
Knee Documentation Committee (IKDC) knee ligation evaluation system, 3 patients
(4.7%) were B, 18 patients (28.12%) were C and 43 patients (67.18%) were
revealed as D in preoperative term. In the last postoperative examination, 41
patients (64.06%) were included in the group A, 21 patients (32.81%) B and 2
patients (3.12%) were included in the group C. The mean femoral tunnel obliquity was found as 41.2±7.2°.

Conclusion: The oblique femoral tunnel placement is thought to be of greater
benefit to the rotational stability of the ACL. As a result of this study, we
are of the opinion that the application of anterior cruciate ligament with an
anatomical technique using an autogenous hamstring tendon graft is more
beneficial to the functional outcome of femoral tunnel obliquity increase.

Keywords

Anterior cruciate ligament reconstruction, rupture, arthroscopy

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