Ön Çapraz Bağ Rekonstrüksiyonunda All-Inside Yöntem ile Transtibial Yöntemin Erken-Orta Dönem Sonuçlarının Karşılaştırılması

Öz

Giriş: Bu çalışma, ÖÇB rekonstrüksiyonunda transtibial ve All-inside tekniklerini karşılaştırmaktadır. Yöntem: Akut veya kronik ÖÇB rüptürü olan, transtibial veya All-inside tekniklerinden biriyle rekonstrüksiyon yapılan ve hamstring otogrefti kullanılan hastalar retrospektif olarak çalışmaya dahil edildi. Bulgular: Çalışmaya 22'si transtibial teknikle, 23'ü All-inside tekniğiyle opere edilen 45 hasta dahil edildi. Yaş, cinsiyet dağılımı ve VKİ değerleri benzerdi. All-inside grubunda postoperatif erken dönemde daha iyi klinik sonuçlar elde edilirken, 2 yıllık takipte sonuçlar her iki grupta da benzerdi. Sonuç: Transtibial ve All-inside teknikleri her ikisi de güvenilirdir ve ÖÇB rekonstrüksiyonlarında iyi klinik sonuçlar vaat etmektedir.

Anahtar Kelimeler

• ACL
• All-inside
• transtibial
• reconstruction

COMPARISON OF THE EARLY-MIDDLE PERIOD RESULTS OF THE ALL-INSIDE METHOD AND THE TRANSTIBIAL METHOD IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Öz

ABSTRACT: Introduction: This study compares transtibial and All-inside techniques frequently used in ACL reconstruction. Methods: Patients with acute or chronic ACL rupture, reconstruction with one of the transtibial and All-inside techniques, using hamstring autograft, having adequate pre- and postoperative documentation and completing the 24th postoperative month were included in the study and compared retrospectively. Results: Forty-five patients, 22 of whom were operated on with the transtibial technique and 23 with the All-inside technique, were included in the study. Age, sex-sex distribution and BMI values were similar. While better clinical results were obtained in the early postoperative period in the all-inside group, the results were identical in both groups at 2-year follow-ups. Conclusion: Transtibial and All-inside techniques are reliable and promise good clinical results in ACL reconstructions.

Anahtar Kelimeler

• ACL
• All-inside
• transtibial
• reconstruction

Kaynakça

1. 1. Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W. The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med. 2007;35(2):223-7.
2. 2. Musahl V, Kopf S, Rabuck S, Becker R, van der Merwe W, Zaffagnini S, et al. Rotatory knee laxity tests and the pivot shift as tools for ACL treatment algorithm. Knee Surg Sports Traumatol Arthrosc. 2012;20(4):793-800.
3. 3. Nishimoto K, Kuroda R, Mizuno K, Hoshino Y, Nagamune K, Kubo S, et al. Analysis of the graft bending angle at the femoral tunnel aperture in anatomic double bundle anterior cruciate ligament reconstruction: a comparison of the transtibial and the far anteromedial portal technique. Knee Surg Sports Traumatol Arthrosc. 2009;17(3):270-6.
4. 4. Lubowitz JH, Amhad CH, Anderson K. All-Inside Anterior Cruciate Ligament Graft-Link Technique: Second-Generation, No-Incision Anterior Cruciate Ligament Reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2011;27(5):717-27.
5. 5. Blackman AJ, Stuart MJ. All-inside anterior cruciate ligament reconstruction. J Knee Surg. 2014;27(5):347-52.
6. 6. Desai VS, Anderson GR, Wu IT, Levy BA, Dahm DL, Camp CL, et al. Anterior Cruciate Ligament Reconstruction With Hamstring Autograft: A Matched Cohort Comparison of the All-Inside and Complete Tibial Tunnel Techniques. Orthop J Sports Med. 2019;7(1):2325967118820297.
7. 7. Lubowitz JH, Schwartzberg R, Smith P. Randomized controlled trial comparing all-inside anterior cruciate ligament reconstruction technique with anterior cruciate ligament reconstruction with a full tibial tunnel. Arthroscopy. 2013;29(7):1195-200.
8. 8. Benea H, d'Astorg H, Klouche S, Bauer T, Tomoaia G, Hardy P. Pain evaluation after all-inside anterior cruciate ligament reconstruction and short term functional results of a prospective randomized study. Knee. 2014;21(1):102-6.

9. 9. Volpi P, Bait C, Cervellin M, Denti M, Prospero E, Morenghi E, et al. No difference at two years between all inside transtibial technique and traditional transtibial technique in anterior cruciate ligament reconstruction. Muscles Ligaments Tendons J. 2014;4(1):95-9.
10. 10. Yasen SK, Borton ZM, Eyre-Brook AI, Palmer HC, Cotterill ST, Risebury MJ, et al. Clinical outcomes of anatomic, all-inside, anterior cruciate ligament (ACL) reconstruction. Knee. 2017;24(1):55-62.
11. 11. Brandsson S, Faxén E, Eriksson BI, Swärd L, Lundin O, Karlsson J. Reconstruction of the anterior cruciate ligament: comparison of outside-in and all-inside techniques. Br J Sports Med. 1999;33(1):42-5.