Introduction. Anterior cruciate ligament (ACL) injury is the most common injury to the stabilizing ligaments of the knee. Despite the technical and rehabilitative advances in primary ACL repair, the frequency of ACL re-rupture remains high. The study is aimed to analyze the long-term outcomes of the two types of ACL revision surgery to restore knee joint function (BTB vs. ST+GT+PLT). Methods. We performed a prospective survey using commonly accepted questionnaires: Lysholm Knee Functioning Scale, and Subjective Knee Evaluation Form, 2000 IKDC. After the two kinds of reconstruction, BTB and ST+GT+PLT, patients of the two groups were interviewed at baseline, 16-17 weeks, and 44-46 weeks after surgery. Nonparametric tests were used: Wilcoxon for checking the differences between the two samples of paired measurements and Wald-Wolfowitz for small unrelated samples. For all tests, a two-sided type I error (p ≤ 0.05) was assumed statistically significant with a 95% confidence interval. Results. In 2020-2021, we performed fourteen reconstructive operations with autografts, eight with BTB autografts, and six using combined ST+GT+PLT one. Pain syndrome duration (days): 28 ± 5.5 vs. 21.2 ± 5.9 (p=0.044). There were no differences between the two groups on the Lysholm scale at baseline (p 0.56); after 16-17 weeks (p=0.83); after 44-46 weeks (p=0.83); on the IKDC scale at baseline (p=0.17). Differences were revealed on the IKDC scale after 16-17 weeks - Me 75 scores vs. 81 (p=0.0028); after 44-46 weeks - Me 76 scores vs. 81 (p=0.0008). Conclusion. In general, the ST+GT+PLT technique is found to be more promising for athletes, as it better meets the requirements of patients with an active lifestyle due to the following advantages: performing the surgery in one stage, which accelerates the knee function restoration; establishing a more massive and, at the same time elastic autograft (> 8.5 mm); reducing the duration of pain after surgery and decreasing the risk of developing osteoarthritis of the patellofemoral joint.
Erik K. Raimagambetov1, Bagdat E. Balbossynov1, Marat N. Urazayev1, Nurzhan M. Assanov1, 1 Academician N.D. Batpenov National Scientific Center of Traumatology and Orthopedics, Nur-Sultan city, Republic of Kazakhstan.
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Raimagambetov E.K., Balbossynov B.E., Urazayev M.N., Assanov N.M. Preliminary findings of the knee anterior cruciate ligament one-stage reconstruction // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 2, pp. 40-47. doi 10.34689/SH.2022.24.2.005