Tahmasebi Mn, Ayati Firoozabadi M, Panjavi B, Kaseb Mh,
Volume 69, Issue 2 (5-2011)
Abstract
Background: One of the most common orthopedic complaints is direct or indirect trauma to the knee with torn anterior cruciate ligament (ACL). Reconstruction of the torn ACL is emphatically offered in active individuals as by this operation, we prevent osteoarthritis, knee instability and injury to the meniscus. There are numerous methods for graft fixation in the femoral tunnel in ACL reconstruction. If the graft proves to be stable after the operation, patients would not complain of giving way knee joints. In this clinical trial, we compared transfemoral pinning with endobutton fixation of hamstring graft in arthroscopic ACL reconstruction by examining knee stability and use of other relevant functional tests.
Methods: Fourteen Patients who had undergone arthroscopic ACL reconstruction in Shariati Hospital during the years 2008-2009 and were being followed up were evaluated at least 15 months post-operatively by physical examination and the use of an
arthrometer made by the Faculty of Mechanics of Sharif Technical University.
Results: The results showed that two out of seven patients in which their ACL had been reconstructed by hamstring graft fixation by endobutton technique, and in one out of seven patients who had undergone ACL reconstruction by hamstring graft fixation through transfemoral pinning, Lachmann test (in 25 position) was greater than 5 mm but there were not any complaints of giving way knee joints.
Conclusion: The clinical results of ACL reconstruction by transfemoral pinning technique seems to be superior to the reconstruction by endobutton technique.
Tahmasebi Mn, Enayati B, Enayati B,
Volume 69, Issue 9 (12-2011)
Abstract
Background: Anterior cruciate ligament (ACL) reconstruction is a first choice treatment for ACL-deficient knees, and arthroscopic single-bundle reconstruction has been widely accepted around the world in this regard. Although, such single-bundle reconstructions result in sufficient knee stability in most cases, but some patients have not been satisfied with postsurgical results in both short-term and long term clinical studies. One of the reasons for these unsatisfactory results could be related to the fact that normal function of the native ACL has not been restored by the traditional ACL reconstruction which uses only a single-bundle graft. The natural ACL consists of a 3-dimensional structure with multibundle fascicles, which can be anatomically divided into 2 main bundles, the anteromedial (AM) and the posterolateral (PL) bundles named for the orientation of their tibial insertions. The purpose of the present study was to compare double-bundle and single-bundle ACL reconstruction.
Methods: Twenty-two patients with anterior cruciate ligament tear who were candidates for ACL reconstruction were enrolled in the study undertaken in Shariati Hospital from 2009 to 2010. Fourteen patients underwent single-bundle and 8 patients double-bundle ACL reconstruction. The patients were evaluated by arthrometer and physical examination in postoperation follow up visit at least 9 months after the operations.
Results: Four out of 14 patients with single-bundle reconstruction had knee joint translation greater than 5 mm but nobody had knee translation more than 5 mm in the double-bundle reconstruction group.
Conclusion: Double-bundle ACL reconstruction seems to be more stable than single-bundle ACL reconstruction.
