The Results Of Reconstruction Of The Anterior Cruciate Ligament Using The “Endobutton CL” System And Four-Strand Hamstring Tendon Autografts

Abstract

Objective: The aim of the study was to evaluate the results of anterior cruciate ligament (ACL) reconstruction using a hamstring tendon autograft. Material and Method: The study included 74 male, 2 female patients (mean age 26,7 years; range 17 to 43 years) with chronic ACL ruptures. Invol-vement was in the right knee in 39 patients, and in the left knee in 37 patients. All the patients were treated with a four-strand hamstring autograft, Endobutton CL femoral fixation and an interference screw on the tibial side. All patients had an ACL reconstruction with an autogenous four-strand hamstring graft. Forty-one patients received treatment for other meniscal pathologies. All patients followed a similar accelerated rehabilitation program after surgery. Final evaluations were made using the Lysholm and International Knee Documentation Committee (IKDC) scoring systems, Cincinati and the Tegner activity rating system in the final follow-up. Results: The Lysholm scores were good and excellent for 67 patients (88,2 %) and the IKDC scores were grade A or B in 68 patients (89,4 %) and grade C in 8 patients (10,5 %). Radiographic examination showed mild (three patients) or moderate (two patients) degenerative changes in the knee joint. Compared with the normal side, no flexion or extension losses occurred in the affected knees. Conclusion: Reconstruction of the ACL using four-strand hamstring tendons and Endobutton CL femoral fixation may be a safe and effective method, resulting in considerably high success rates.

Keywords

• Anterior cruciate ligament, Arthroscopy, Reconstructive surgery, Endobutton CL.

Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi ve Dört Katlı Hamstring Tendon Otogrefti ile Rekonstrüsiyonunun Sonuçları

Öz

Amaç: Hamstring tendon otogrefti kullanılarak ön çapraz bağ (ÖÇB) rekonstrüksiyonu yapılan hastaların sonuçları değerlendirildi. Gereç ve Yöntem: Çalışmaya kronik ÖÇB yırtığı olan 74 erkek, 2 bayan hasta (ort. yaş 26,7; dağılım 17-43) alındı. Otuz dokuz hastada sağ dizde, 37 hastada sol dizde lezyon vardı. Tüm hastalar artroskopik olarak dört katlı otogreft hamstring tendonu, proksimal tespit Endobutton CL sistemi ve tibial tarafta interferans vidası ile tedavi edildi. Kırk bir hastanın, cerrahi sırasında tespit edilen menisküs problemlerine parsiyel menisektomi uygulandı. Bütün hastalara postoperatif dönemde benzer hızlandırılmış iyileştirme programları uygulandı. Hastalar ameliyat öncesi ve sonrası Lysholm, International Knee Documentation Committee (IKDC) skorlama, Cincinati ve Tegner aktivite derecelendirme sistemleri ile takip edildiler. Bulgular: Lysholm skorlamasında 67 hasta (% 88,2) iyi ve mükemmel sonuç, IKDC skorlamasına göre 68 hasta (% 89,4) A veya B, 8 hasta (% 10,5) ise C olarak değerlendirildi. Radyografik değerlendirmede, üç hastanın diz ekleminde hafif, iki hastada orta derecede dejeneratif değişiklikler gözlendi. Sağlam tarafla karşılaştırıldığında, hastalarda fleksiyon ve ekstansiyon kaybı gözlenmedi. Sonuç: ÖÇB rekonstrüksiyonunda dörtlü hamstring tendonu ve Endobutton CL sistemi ile yapılanlan cerrahi tedavinin güvenli ve orta dönem sonuçlarının başarılı olduğu görüşüne varılmıştır.

Anahtar Kelimeler

• Ön çapraz bağ, Artroskopi, Rekonstrüktif cerrahi, Endobutton CL.

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