Применение нового способа подготовки аутотрансплантата для пластики передней крестообразной связки

Abstract

Background . Currently, work continues to improve the methods of arthroscopic reconstruction of the anterior cruciate\xa0ligament with an autograft, aimed at reducing the risk of postoperative failure. Aim of the study . To assess the immediate results of using a new method of preparing an autograft for anterior cruciate ligament plasty. Materials and methods. The analysis of the results of surgical treatment of 28 patients with old complete traumatic\xa0rupture of the anterior cruciate ligament, who were treated in the Department of traumatology and orthopedics of the\xa0Irkutsk Scientific Center of Surgery and Traumatology, was carried out. The patients were men aged 18 to 40 years.\xa0The common thing for all patients was the All-inside arthroscopic plasty of the anterior cruciate ligament.\xa0Two groups of patients were formed depending on the method of preparation of the autograft. The first group consisted\xa0of 18 patients in whom a well-known technique was used, including the formation of a four-bundle autograft from one\xa0tendon of the semitendinosus muscle. In 10 patients of the second group, a new method of preparing an autograft was\xa0used, including the stage of preliminary determination of the required length and thickness of the autograft, and the\xa0stage of forming an autograft from the tendon of the semitendinosus and gracilis muscles on the common tendon pedicle. Results . Comparative analysis of the immediate results of arthroscopic plasty of the anterior cruciate ligament with\xa0an autograft in case of its old complete traumatic injury revealed a significantly lower number of undesirable consequences when using a new method of preparing an autograft. In two cases, persistence of\xa0 the pain syndrome associated with arthritic changes in the joint was observed, in one patient there was a\xa0 restriction of movements in the knee joint, no synovitis, a sensation of instability of the knee joint, ruptures\xa0 and detachments of the autograft were found.\xa0All patients were satisfied with the achieved result. Conclusion. A new method of preparing an autograft for plasty of the anterior cruciate ligament allows\xa0 achieving anatomical reconstruction of the anterior cruciate ligament, optimal function of the knee joint,\xa0 reducing pain, significantly\xa0reducing the risk of developing knee instability, ruptures and abruptions of the autograft in the postoperative period due\xa0to an individual approach, increasing the strength of the autograft and the strength of its fixation in the bone canals.