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

Yıl 2013, Cilt: 18 Sayı: 4, 208 - 212, 01.08.2013

Öz

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.

Kaynakça

  • Gottlob CA, Baker CL, Pellissier JM. Colvin L. Cost effectiveness of anterior crucite ligament reconstruction in young adults. Clin Orthop Relat Res 1999; 367: 272-82.
  • Adachi N, Ochi M, Uchio Y, Iwasa J, Ryoke K, Kuriwaka M. Mechanoreceptors in the anterior Cruciate ligament contribute to the joint position sense. Acta Orthop Scand 2002; 73: 330
  • Beynnon BD, Johnson RJ, Fleming BC, et al. Anterior cruciate ligament replacement: comparison of bone-patellar tendonbone grafts with twostrand hamstring grafts: a prospective, randomized study. J Bone Joint Surg Am 2002; 84: 1503-13.
  • Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F. Anterior cruciate ligament reconstruction: bone-patellar tendonbone compared with double semitendinosus and grasilis tendon grafts, a prospective, randomized clinical trial. J Bone Joint Surg Am 2004; 86: 2143-55.
  • Freedman K, D’Amato M, Nedeff D, Ari Kaz, Bach B. Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 2003; 31: 2-11.
  • Valentin A, Engström B, Werner S. ACL reconstruction: patellar tendon versus hamstring grafts economical aspects. Knee Surg Sports Traumatol Arthrosc 2006; 4: 536-41.
  • Serbest S, Tosun HB, Yılmaz E. Hamstring Tendon Otogrefti ile Ön Çapraz Bağ Rekonstrüksiyonu. Fırat Tıp Dergisi 2011; 16: 186-9.
  • Gorschewsky O, Klakow A, Riechert K, Pitzl M, Becker R. Clinical comparison of the Tutoplast allograft and autologous patellar tendon (bone-patellar tendon-bone) for the reconstruction of the anterior cruciate ligament: 2- and 6-year results. Am J Sports Med 2005; 33: 1202-9.
  • Peterson RK, Shelton WR, Bomboy AL. Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: A 5-year follow-up. Arthroscopy 2001; 17: 9-13.
  • Tashiro T, Kurosawa H, Kawakami A, Hikita A, Fukui N. Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction. A detailed evaluation with comparison of single- and doubletendon harvest. Am J Sports Med 2003; 31: 522-9.
  • Chun CH, Han HJ, Lee BC, Kim DC, Yang JH. Histologic findings of anterior cruciate ligament reconstruction with achilles allograft. Clin Orthopaedics &Related Res 2004; 421: 273Harner CD, Olson E, Irrgang JJ, Silverstein S, Fu FH, Silbey M. Allograft versus autograft anterior cruciate ligament reconstruction: 3 to 5 year outcome. Clin Orthopaedics & Related Res 1996; 324: 134-44.
  • Indelli P, Francesco P, Michael F, Gary S. Anterior cruciate ligament reconstruction using cryopreserved allografts. Clin Orthopaedics & Related Res 2004; 420: 268-75.
  • Feller JA, Webster KE, Gavin B. Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft. Knee Surg Sports Traumatol Arthrosc 2001; 9: 260-6.
  • Kartus J, Movin T, Karlsson J. Donor-site morbidity and anterior knee problems after anterior cruciate ligament reconstruction using autografts. Arthroscopy 2001; 17: 971-80.
  • Shelton WR, Papendick L, Dukes AD. Autograft versus allograft anterior cruciate ligament reconstruction. Arthroscopy 1997; 13: 446-9.
  • Spicer DD, Blagg SE, Unwin AJ, Allum RL. Anterior knee symptoms after four-strand hamstring tendon anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2000; 8: 286-9.
  • Gillquist J. Odensten M. Artrhroscopic reconstruction of the anterior cruciate ligament. Arthroscopy 1996; 4: 5-9.
  • Howell G, Wertheimer C, Johnson RJ, et al. Artrhroscopic strain gauge measurement of the anterior cruciate ligament. Arthroscopy 2000; 6: 198-204.
  • Eriksson K, Anderberg P, Hamberg P, et al. A Comparision of quadruple semitendinosus and patellar tendon graft in reconstruction of the anterior cruciate ligament. J Bone Joint Surg 2001; 83: 622-40.
  • Williams RJ, Hyman J, Petrigliano F. Anterior cruciate ligament reconstruction with a four-strand hamstring tendon autograft. J Bone Joint Surg Am 2004; 86: 225-32.
  • Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogenous semitendinosus and grasilis tendons. Am J Sports Med 1995; 23: 706-14.
  • Brand J Jr, Weiler A, Caborn DN, Brown CH Jr, Johnson DL. Graft fixation in cruciate ligament reconstruction. Am J Sports Med 2000; 28: 761-74.
  • Honl M, Carrero V, Hille E, Schneider E, Morlock MM. Bone-patellar tendon-bone grafts for anterior cruciate ligament reconstruction: an in vitro comparison of mechanical behavior under failure tensile loading and cyclic submaximal tensile loading. Am J Sports Med 2002; 30: 549-57.
  • Price R, Stoney J, Brown G. Prospective randomized comparison of endobutton versus cross-pin femoral fixation in hamstring anterior cruciate ligament reconstruction with 2-year follow-up. ANZ J Surg 2010; 80: 162-5.
  • Wilson TC, Kantaras A, Atay A, Johnson DL. Tunnel enlargement after anterior cruciate ligament surgery. Am J Sports Med 2004; 32: 543-9.
  • Fauno P, Kaalund S. Tunnel widening after hamstring anterior cruciate ligament reconstruction is influenced by the type of graft fixation used: a prospective randomized study. Arthroscopy 2005; 21: 1337-41.
  • Kong CG, In Y, Kim GH, Ahn CY. Cross Pins versus Endobutton Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction: Minimum 4-Year Follow-Up. Knee Surg Relat Res 2012; 24: 34-9.
  • Fu FH, Bennett CH, Ma CB, Menetrey J, Lattermann C. Current trends in anterior cruciate ligament reconstruction. Part II. Operative procedures and clinical correlations. Am J Sports Med 2000; 28: 124-30.
  • Hame SL, Markolf KL, Hunter DM, Oakes DA, Zoric B. Effects of notchplasty and femoral tunnel position on excursion patterns of an anterior cruciate ligament graft. Arthroscopy 2003; 19: 340-5.
  • Taser O. Reconstruction of anterior cruciate ligament with patellar tendon with bone blocks. [Article in Turkish] Acta Orthop Traumatol Turc 1999; 33: 405-11.
  • Howell SM, Taylor MA. Brace-free rehabilitation, with early return to activity, for knees reconstructed with a doubleloopedsemitendinosus and gracilis graft. J Bone Joint Surg Am 1996; 78: 814-25.
  • Beynnon BD, Johnson RJ, Fleming BC. The science of anterior cruciate ligament rehabilitation. Clin Orthop Relat Res 2002; 402: 9-20.
  • Warren RD, Andrew EL, Richard YH, Gordon SS. Occupational disability after hospitalization for the treatment of an injury of the anterior cruciate ligament. J Bone Joint Surg Am 2003; 85: 1656-66.
  • Wexler G, Hurwitz DE, Bush-Joseph CA, Andriacchi TP, Bach BR Jr. Functional gait adaptations in patients with anterior cruciate ligament deficiency over time. Clin Orthop Relat Res 1998; 348: 166-75.
  • Aglietti P, Buzzi R, Menchetti PM, Giron F. Arthroscopically assisted semitendinosus and gracilis tendon graft in reconstruction for acute anterior cruciate ligament injuries in athletes. Am J Sports Med 1996; 24: 726-31.
  • Eriksson K, Anderberg P, Hamberg P, Olerud P, Wredmark T. There are differences in early morbidity after ACL reconstruction when comparing patellar tendon and semitendinosus tendon graft. A prospective randomized study of 107 patients. Scand J Med Sci Sports 2001; 11: 170-7.

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

Yıl 2013, Cilt: 18 Sayı: 4, 208 - 212, 01.08.2013

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.

Kaynakça

  • Gottlob CA, Baker CL, Pellissier JM. Colvin L. Cost effectiveness of anterior crucite ligament reconstruction in young adults. Clin Orthop Relat Res 1999; 367: 272-82.
  • Adachi N, Ochi M, Uchio Y, Iwasa J, Ryoke K, Kuriwaka M. Mechanoreceptors in the anterior Cruciate ligament contribute to the joint position sense. Acta Orthop Scand 2002; 73: 330
  • Beynnon BD, Johnson RJ, Fleming BC, et al. Anterior cruciate ligament replacement: comparison of bone-patellar tendonbone grafts with twostrand hamstring grafts: a prospective, randomized study. J Bone Joint Surg Am 2002; 84: 1503-13.
  • Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F. Anterior cruciate ligament reconstruction: bone-patellar tendonbone compared with double semitendinosus and grasilis tendon grafts, a prospective, randomized clinical trial. J Bone Joint Surg Am 2004; 86: 2143-55.
  • Freedman K, D’Amato M, Nedeff D, Ari Kaz, Bach B. Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 2003; 31: 2-11.
  • Valentin A, Engström B, Werner S. ACL reconstruction: patellar tendon versus hamstring grafts economical aspects. Knee Surg Sports Traumatol Arthrosc 2006; 4: 536-41.
  • Serbest S, Tosun HB, Yılmaz E. Hamstring Tendon Otogrefti ile Ön Çapraz Bağ Rekonstrüksiyonu. Fırat Tıp Dergisi 2011; 16: 186-9.
  • Gorschewsky O, Klakow A, Riechert K, Pitzl M, Becker R. Clinical comparison of the Tutoplast allograft and autologous patellar tendon (bone-patellar tendon-bone) for the reconstruction of the anterior cruciate ligament: 2- and 6-year results. Am J Sports Med 2005; 33: 1202-9.
  • Peterson RK, Shelton WR, Bomboy AL. Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: A 5-year follow-up. Arthroscopy 2001; 17: 9-13.
  • Tashiro T, Kurosawa H, Kawakami A, Hikita A, Fukui N. Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction. A detailed evaluation with comparison of single- and doubletendon harvest. Am J Sports Med 2003; 31: 522-9.
  • Chun CH, Han HJ, Lee BC, Kim DC, Yang JH. Histologic findings of anterior cruciate ligament reconstruction with achilles allograft. Clin Orthopaedics &Related Res 2004; 421: 273Harner CD, Olson E, Irrgang JJ, Silverstein S, Fu FH, Silbey M. Allograft versus autograft anterior cruciate ligament reconstruction: 3 to 5 year outcome. Clin Orthopaedics & Related Res 1996; 324: 134-44.
  • Indelli P, Francesco P, Michael F, Gary S. Anterior cruciate ligament reconstruction using cryopreserved allografts. Clin Orthopaedics & Related Res 2004; 420: 268-75.
  • Feller JA, Webster KE, Gavin B. Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft. Knee Surg Sports Traumatol Arthrosc 2001; 9: 260-6.
  • Kartus J, Movin T, Karlsson J. Donor-site morbidity and anterior knee problems after anterior cruciate ligament reconstruction using autografts. Arthroscopy 2001; 17: 971-80.
  • Shelton WR, Papendick L, Dukes AD. Autograft versus allograft anterior cruciate ligament reconstruction. Arthroscopy 1997; 13: 446-9.
  • Spicer DD, Blagg SE, Unwin AJ, Allum RL. Anterior knee symptoms after four-strand hamstring tendon anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2000; 8: 286-9.
  • Gillquist J. Odensten M. Artrhroscopic reconstruction of the anterior cruciate ligament. Arthroscopy 1996; 4: 5-9.
  • Howell G, Wertheimer C, Johnson RJ, et al. Artrhroscopic strain gauge measurement of the anterior cruciate ligament. Arthroscopy 2000; 6: 198-204.
  • Eriksson K, Anderberg P, Hamberg P, et al. A Comparision of quadruple semitendinosus and patellar tendon graft in reconstruction of the anterior cruciate ligament. J Bone Joint Surg 2001; 83: 622-40.
  • Williams RJ, Hyman J, Petrigliano F. Anterior cruciate ligament reconstruction with a four-strand hamstring tendon autograft. J Bone Joint Surg Am 2004; 86: 225-32.
  • Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogenous semitendinosus and grasilis tendons. Am J Sports Med 1995; 23: 706-14.
  • Brand J Jr, Weiler A, Caborn DN, Brown CH Jr, Johnson DL. Graft fixation in cruciate ligament reconstruction. Am J Sports Med 2000; 28: 761-74.
  • Honl M, Carrero V, Hille E, Schneider E, Morlock MM. Bone-patellar tendon-bone grafts for anterior cruciate ligament reconstruction: an in vitro comparison of mechanical behavior under failure tensile loading and cyclic submaximal tensile loading. Am J Sports Med 2002; 30: 549-57.
  • Price R, Stoney J, Brown G. Prospective randomized comparison of endobutton versus cross-pin femoral fixation in hamstring anterior cruciate ligament reconstruction with 2-year follow-up. ANZ J Surg 2010; 80: 162-5.
  • Wilson TC, Kantaras A, Atay A, Johnson DL. Tunnel enlargement after anterior cruciate ligament surgery. Am J Sports Med 2004; 32: 543-9.
  • Fauno P, Kaalund S. Tunnel widening after hamstring anterior cruciate ligament reconstruction is influenced by the type of graft fixation used: a prospective randomized study. Arthroscopy 2005; 21: 1337-41.
  • Kong CG, In Y, Kim GH, Ahn CY. Cross Pins versus Endobutton Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction: Minimum 4-Year Follow-Up. Knee Surg Relat Res 2012; 24: 34-9.
  • Fu FH, Bennett CH, Ma CB, Menetrey J, Lattermann C. Current trends in anterior cruciate ligament reconstruction. Part II. Operative procedures and clinical correlations. Am J Sports Med 2000; 28: 124-30.
  • Hame SL, Markolf KL, Hunter DM, Oakes DA, Zoric B. Effects of notchplasty and femoral tunnel position on excursion patterns of an anterior cruciate ligament graft. Arthroscopy 2003; 19: 340-5.
  • Taser O. Reconstruction of anterior cruciate ligament with patellar tendon with bone blocks. [Article in Turkish] Acta Orthop Traumatol Turc 1999; 33: 405-11.
  • Howell SM, Taylor MA. Brace-free rehabilitation, with early return to activity, for knees reconstructed with a doubleloopedsemitendinosus and gracilis graft. J Bone Joint Surg Am 1996; 78: 814-25.
  • Beynnon BD, Johnson RJ, Fleming BC. The science of anterior cruciate ligament rehabilitation. Clin Orthop Relat Res 2002; 402: 9-20.
  • Warren RD, Andrew EL, Richard YH, Gordon SS. Occupational disability after hospitalization for the treatment of an injury of the anterior cruciate ligament. J Bone Joint Surg Am 2003; 85: 1656-66.
  • Wexler G, Hurwitz DE, Bush-Joseph CA, Andriacchi TP, Bach BR Jr. Functional gait adaptations in patients with anterior cruciate ligament deficiency over time. Clin Orthop Relat Res 1998; 348: 166-75.
  • Aglietti P, Buzzi R, Menchetti PM, Giron F. Arthroscopically assisted semitendinosus and gracilis tendon graft in reconstruction for acute anterior cruciate ligament injuries in athletes. Am J Sports Med 1996; 24: 726-31.
  • Eriksson K, Anderberg P, Hamberg P, Olerud P, Wredmark T. There are differences in early morbidity after ACL reconstruction when comparing patellar tendon and semitendinosus tendon graft. A prospective randomized study of 107 patients. Scand J Med Sci Sports 2001; 11: 170-7.
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Sancar Serbest Bu kişi benim

Erhan Yılmaz Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 18 Sayı: 4

Kaynak Göster

APA Serbest, S., & Yılmaz, E. (2013). Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi ve Dört Katlı Hamstring Tendon Otogrefti ile Rekonstrüsiyonunun Sonuçları. Fırat Tıp Dergisi, 18(4), 208-212.
AMA Serbest S, Yılmaz E. Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi ve Dört Katlı Hamstring Tendon Otogrefti ile Rekonstrüsiyonunun Sonuçları. Fırat Tıp Dergisi. Ağustos 2013;18(4):208-212.
Chicago Serbest, Sancar, ve Erhan Yılmaz. “Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi Ve Dört Katlı Hamstring Tendon Otogrefti Ile Rekonstrüsiyonunun Sonuçları”. Fırat Tıp Dergisi 18, sy. 4 (Ağustos 2013): 208-12.
EndNote Serbest S, Yılmaz E (01 Ağustos 2013) Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi ve Dört Katlı Hamstring Tendon Otogrefti ile Rekonstrüsiyonunun Sonuçları. Fırat Tıp Dergisi 18 4 208–212.
IEEE S. Serbest ve E. Yılmaz, “Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi ve Dört Katlı Hamstring Tendon Otogrefti ile Rekonstrüsiyonunun Sonuçları”, Fırat Tıp Dergisi, c. 18, sy. 4, ss. 208–212, 2013.
ISNAD Serbest, Sancar - Yılmaz, Erhan. “Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi Ve Dört Katlı Hamstring Tendon Otogrefti Ile Rekonstrüsiyonunun Sonuçları”. Fırat Tıp Dergisi 18/4 (Ağustos 2013), 208-212.
JAMA Serbest S, Yılmaz E. Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi ve Dört Katlı Hamstring Tendon Otogrefti ile Rekonstrüsiyonunun Sonuçları. Fırat Tıp Dergisi. 2013;18:208–212.
MLA Serbest, Sancar ve Erhan Yılmaz. “Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi Ve Dört Katlı Hamstring Tendon Otogrefti Ile Rekonstrüsiyonunun Sonuçları”. Fırat Tıp Dergisi, c. 18, sy. 4, 2013, ss. 208-12.
Vancouver Serbest S, Yılmaz E. Ön Çapraz Bağ Yırtığının “Endobutton CL” Sistemi ve Dört Katlı Hamstring Tendon Otogrefti ile Rekonstrüsiyonunun Sonuçları. Fırat Tıp Dergisi. 2013;18(4):208-12.