PRELIMINARY FINDINGS OF THE KNEE ANTERIOR CRUCIATE LIGAMENT ONE-STAGE RECONSTRUCTION
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, https://orcid.org/0000-0002-9032-3860 Bagdat E. Balbossynov1, https://orcid.org/0000-0003-0538-9564 Marat N. Urazayev1, https://orcid.org/0000-0002-8814-5479 Nurzhan M. Assanov1, https://orcid.org/0000-0003-1277-4321 1 Academician N.D. Batpenov National Scientific Center of Traumatology and Orthopedics, Nur-Sultan city, Republic of Kazakhstan.
1. ГудзьЮ.В.,ВетошкинА.А.Cпециализированная медицинская помощь пациентамспатологией хряща коленногосустава: учебно-методическое пособие. Всероссийский центрэкстренной и радиационной медицины им. А.М. Никифорова МЧС России. СПб.:ООО«НПОПБАС»,2020.58с. https://nrcerm.ru/files/book/metod_4_2020.pdf. (Дата обращения:15.07.2020) 2. Angelozzi M., Madama M., Corsica C., Calvisi V., Properzi G., McCaw S.T., Cacchio A. Rate of force development as an adjunctive outcome measure for return-to-sport decisions after anterior cruciate ligament reconstruction // The Journal of orthopaedic and sports physical therapy, 2012. 42(9), P. 772–780. https://doi.org/10.2519/jospt.2012.3780. 3. Ardern C.L., Taylor N.F., Feller J.A., Webster K.E. Fifty-five percent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and metaanalysis including aspects of physical functioning and contextual factors // Br J Sports Med. 2014. 48(21). P. 1543–52. 4. Baer G.S., Harner C.D. Clinical outcomes of allograft versus autograft in anterior cruciate ligament reconstruction //Clin Sports Med. 2007, Oct. 26(4):661-81. 5. Battaglia M.J., Cordasco F.A., Hannafin J.A., Rodeo S.A., O’Brien S.J., Altchek D.W. et al. Results of revision anterior cruciate ligament surgery // Am J Sports Med. 2007. 35(12):2057–66. 6. Biau D.J., Tournoux C., Katsahian S., Schranz P., Nizard R. ACL reconstruction: a meta-analysis of functional scores //ClinOrthopRelat Res. 2007, May. 458():180-7. 7. Biau D.J., Tournoux C.et al. Bone-patellar tendon-bone autografts versus hamstring autografts for reconstruction of anterior cruciate ligament: meta-analysis // BMJ. 2006, Apr 29. 332(7548):995-1001. 8. Brophy R.H., Schmitz L., Wright R.W. et al. Return to play and future ACL injury risk after ACL reconstruction in soccer athletes from the Multicenter Orthopaedic Outcomes Network (MOON) group // The American journal of sports medicine. 2012. 40:2517–22. 9. Chee M.Y., Chen Y., Pearce C.J., Murphy D.P., Krishna L., Hui J.H. et al. Outcome of patellar tendon versus 4-strand hamstring tendon autografts for anterior cruciate ligament reconstruction: a systematic review and meta-analysis of prospective randomized trials // Arthroscopy. 2017. 33(2):450–63. 10. Conte E.J., Hyatt A.E., Gatt C.J., Dhawan A. Hamstring autograft size can be predicted and is a potential risk factor for anterior cruciate ligament reconstruction failure // Arthroscopy. 2014. 30:882–90. 11. van Eck C.F., Martins C.A., Vyas S.M., Celentano U., van Dijk C.N., Fu F.H. Femoral intercondylar notch shape and dimensions in ACL-injured patients // Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2010. 18:1257–62. 12. Engelman G.H., Carry P.M., Hitt K.G., Polousky J.D., Vidal A.F. Comparison of allograft versus autograft anterior cruciate ligament reconstruction graft survival in an active adolescent cohort // The American journal of sports medicine. 2014. 42:2311–18. 13. Gianotti S.M., Marshall S.W., Hume P.A., Bunt L.J. Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study //Sci Med Sport. 2009. Nov. 12(6):622-27. 14. Gormeli C.A., Gormeli G.,Ozturk B.Y. et al.The effect of the intercondylar notch width index on anterior cruciate ligament injuries.a study on groups with unilateral and bilateral ACL injury //ActaOrthop Belg. 2015. 81:240–44. 15. Grassi A., Ardern C.L., MarcheggianiMuccioli G.M., Neri M.P., Marcacci M., Zaffagnini S. Does revision ACL reconstruction measure up to primary surgery? A meta-analysis comparing patientreported and clinician-reported outcomes, and radiographic results // Br J Sports Med. 2016. 50(12):716–24. 16. Grassi A., Zaffagnini S., MarcheggianiMuccioli G.M., Neri M.P., Della Villa S., Marcacci M. After revision anterior cruciate ligament reconstruction, who returns to sport? A systematic review and meta-analysis // Br J Sports Med. 2015. 49(20):1295–304. 17. Hettrich C.M., Dunn W.R., Reinke E.K., Group M., Spindler K.P. The rate of subsequent surgery and predictors after anterior cruciate ligament reconstruction: two- and 6-year follow-up results from a multicenter cohort // The American journal of sports medicine. 2013. 41:1534–40. 18. Hui C., Salmon L.J., Kok A., Maeno S., Linklater J., Pinczewski L.A. Fifteen-year outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft for "isolated" anterior cruciate ligament tear // The American journal of sports medicine, 2011. 39(1), 89–98. 19. Kaeding C.C., Aros B., Pedroza A. et al. Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure From a MOON Prospective Longitudinal Cohort // Sports health. 2011. 3:73–81. 20. Kose O., Deniz G., Ozcan H. et al. A comparison of telephone interview versus onsite completion of Lysholm knee score in patients who underwent arthroscopic ACL reconstruction: are the results equivalent? // Eur J OrthopSurgTraumatol. 2015. 25(6): 1069-72. 21. Lysholm Knee Score. https://medical-club.net/shkaly-po-travmatologii.(accessed:26.07.2018). 22. Magnussen R.A., Lawrence J.T., West R.L., Toth A.P., Taylor D.C., Garrett W.E. Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft // Arthroscopy. 2012. 28:526–31. 23. Maletis G.B., Chen J., Inacio M.C., Funahashi T.T. Age-Related Risk Factors for Revision Anterior Cruciate Ligament Reconstruction: A Cohort Study of 21,304 Patients From the Kaiser Permanente Anterior Cruciate Ligament Registry // Am J Sports Med. 2016, Feb. 44(2):331-6. 24. The MARS group. Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort // Am J Sports Med. 2014. 42(10):2301–10. 25. Morgan J.A., Dahm D., Levy B., Stuart M.J., Group M.S. Femoral tunnel malposition in ACL revision reconstruction // J Knee Surg. 2012. 25:361–68. 26. Niki Y., Hakozaki A., Iwamoto W., Kanagawa H., Matsumoto H., Toyama Y. et al. Factors affecting anterior knee pain following anatomic double-bundle anterior cruciate ligament reconstruction // Knee Surg Sports TraumatolArthrosc. 2012. 20(8):1543–49. 27. Parkkari J., Pasanen K., Mattila V.M., Kannus P., Rimpelä A. The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up // Br J Sports Med. 2008, Jun. 42(6):422-26. 28. Paterno M.V., Rauh M.J., Schmitt L.C., Ford K.R., Hewett T.E. Incidence of Second ACL Injuries 2 Years After Primary ACL Reconstruction and Return to Sport // The American journal of sports medicine. 2014. 42:1567–73. 29. Pinczewski L.A., Lyman J., Salmon L.J., Russell V.J., Roe J., Linklater J. A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial // The American journal of sports medicine, 2007.35(4), 564–74. 30. Reinhardt K.R., Hammoud S., Bowers A.L., Umunna B.P., Cordasco F.A. Revision ACL reconstruction in skeletally mature athletes younger than 18 years //ClinOrthopRelat Res. 2012. Mar. 470(3):835-42. 31. Salmon L.J., Russell V.J., Refshauge K., Kader D., Connolly C., Linklater J., Pinczewski L.A. Long-term outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft: minimum 13-year review // The American journal of sports medicine, 2006.34(5), 721–32. 32. Spragg L., Chen J., Mirzayan R., Love R., Maletis G. The Effect of Autologous Hamstring Graft Diameter on the Likelihood for Revision of Anterior Cruciate Ligament Reconstruction // The American journal of sports medicine. 2016. 44:1475–81. 33. Stephenson R.D., Johnson L.D. Revision reconstruction of ACL and PCL - Operative arthroscopy 4th ed. – D. Johnson et al. 2013. P. 982 - 97. 34. SubjectiveKneeEvaluation Form,2000 IKDC (International Knee Documentation Committee). https://www.codetechnology.com/international-knee-documentation-committee-ikdc/. (19.05.2016) 35. Trojani C., Sbihi A., Djian P. et al. Causes for failure of ACL reconstruction and influence of meniscectomies after revision. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2011. 19:196–201. 36. Webster K.E., Feller J.A., Leigh W.B., Richmond A.K. Younger patients are at increased risk for graft rupture and contralateral injury after anterior cruciate ligament reconstruction // Am J Sports Med. 2014, Mar. 42(3):641-7. 37. Wiggins A.J., Grandhi R.K., Schneider D.K., Stanfield D., Webster K.E., Myer G.D. Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis // The American journal of sports medicine. 2016. 44:1861–76. 38. Wright R.W., Magnussen R.A., Dunn W.R., Spindler K.P.Ipsilateral graft and contralateral ACL rupture at five years or more following ACL reconstruction: a systematic review // J Bone Joint Surg Am. 2011, Jun 15. 93(12):1159-65. References: [1] 1. Gudz' Yu.V., Vetoshkin A.A. Cpetsializirovannaya meditsinskaya pomoshch' patsientam s patologiei khryashcha kolennogo sustava: uchebno-metodicheskoe posobie [Specialized medical care for patients with knee cartilage pathology: a teaching aid.]. Vserossiiskii tsentr ekstrennoi i radiatsionnoi meditsiny im. A.M. Nikiforova MChS Rossii. SPb.: OOO «NPO PB AS» [All-Russian Center for Emergency and Radiation Medicine. A.M. Nikiforov EMERCOM of Russia. St. Petersburg: LLC «NPO PB AS»], 2020. 58 p. https://nrcerm.ru/files/book/metod_4_2020.pdf. (accessed 15.07.2020)
Количество просмотров: 283

Ключевые слова:


Библиографическая ссылка

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

Авторизируйтесь для отправки комментариев