CLINICAL AND FUNCTIONAL OUTCOMES AFTER TWO DIFFERENT ANTERIOR CRUCRIATE LIGAMENT RECONSTRUCTION TECHNIQUES: COMPARISON OF RIGIDFIX AND ENDOBUTTON

Öz

Giriş: Endobutton ve Rigidfix ön çapraz bağ rekonstrüksiyonu (ÖÇBR) için en çok kullanılan tespit yöntemleridir. Laksite, kuvvet, yürüme ve sıçrama açısından bu iki yöntemin birbirine üstünlüğünü araştıran herhangi bir çalışmaya rastlanmamıştır. Amaç: Bu çalışmanın amacı ACLR olan olgularda endobutton veya Rigidfix teknikleri ile laksite, tünel genişliği, izokinetik güç, yürüme ve sıçramanın karşılaştırılmasıdır. Yöntem: Çalışmaya Endobutton (n=13) ve Rigidfix teknikleri (n=13) ile ÖÇBR uygulanan olgular dahil edildi. Kemik tünel genişlemesi BT seri kesitlerinde değerlendirildi ve ön diz laksitesi bir artrometre kullanılarak değerlendirildi. Quadriseps ve Hamstring kas kuvvetleri izokinetik sistem kullanılarak ölçüldü. Yürüyüş analizi ve sıçrama için BTS G-walk kullanıldı. Bulgular: İki grup arasında ön diz laksitesii, tünel genişlemesi, izokinetik kas kuvveti ve sıçrama yüksekliği açısından istatistiksel olarak anlamlı bir fark yoktu. Yürüyüş analizinde, sadece etkilenmemiş yan adım uzunluğu ve pelvik tilt simetri indeksi gruplar arasında anlamlı olarak farklıydı (sırasıyla p=0.045; p=0.038). Sonuçlar: ÖÇBR'li hastalarda hangi tip tespit yöntemi kullanılırsa kullanılsın; tüm parametre değerleri benzerdi. Ayrıca, iki yıllık ameliyattan sonra bile, etkilenen ve etkilenmeyen bacaklar arasında fonksiyonel farklılıklar tespit edildi. Ayrıca, her iki teknikte de istatistiksel olarak anlamlı tünel genişlemesi bulundu. Fiksasyon tekniğine bakılmaksızın ÖÇBR sonrası normal duruma dönmenin tam olarak sağlanamadığı sonucuna varıldı. Bu durumun zamanla bağın yapısı ve eklem kinematiği açısından sorunlara yol açabileceği ifade edilebilir.

Anahtar Kelimeler

• ön çapraz bağ rekonstrüksiyonu
• endobutton
• rigidfix
• fonksiyon

CLINICAL AND FUNCTIONAL OUTCOMES AFTER TWO DIFFERENT ANTERIOR CRUCRIATE LIGAMENT RECONSTRUCTION TECHNIQUES: COMPARISON OF RIGIDFIX AND ENDOBUTTON

Abstract

Background: Endobutton and Rigidfix are the most used fixation methods for anterior cruciate ligament reconstruction (ACLR). No studies were found investigating the superiority of these two methods to each other in terms of laxity, strength, gait and jumping. Aim: The purpose of this study is to compare laxity, tunnel enlargement, isokinetic strength, gait and jump in cases who had ACLR with Endobutton or Rigidfix techniques. Method: The study consisted of cases who received ACLR with Endobutton (n=13) and Rigidfix techniques (n=13). Bone tunnel enlargement was assessed on CT serial sections and anterior knee laxity was evaluated using an arthrometer. Quadriceps and Hamstring muscle strengths were measured using isokinetic system. BTS G-walk was used for gait analysis and jumping. Results: There was no statistically significant difference in anterior knee laxity, tunnel enlargement, isokinetic muscle strength and jump height between two groups. In gait analysis, only uninvolved side stride length and pelvic tilt symmetry index were significantly different between groups (p=0.045; p=0.038 respectively). Conclusions: In patients with ACLR, whichever type of fixation method was used; all of parameter values were similar. Furthermore, even after two years of surgery, functional differences were detected between the affected and unaffected legs. Also, statistically significant tunnel enlargement was found in both techniques. It was concluded that the recovery to normal condition after ACLR is not fully achieved, regardless of the fixation technique. It can be stated that this situation may cause problems in terms of the structure of the ligament and joint kinematics over time.

Keywords

• anterior cruciate ligament reconstruction
• endobutton
• rigidfix
• function

Kaynakça

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