2015 ISAKOS Biennial Congress ePoster #1232
Anterior Cruciate Ligament Surgery in Professional Soccer Players
Jorge Pablo Batista, MD, San Isidro, Buenos Aires ARGENTINA
Rodrigo Maestu, MD, Boulogne, Buenos Aires ARGENTINA
Gerardo Godoy Sanchez, MD, Buenos Aires, C.A.B.A. ARGENTINA
Lucas Logioco, MD, Buenos Aires ARGENTINA
Diego Roncolato, MD, Buenos Aires ARGENTINA
Club Atlético Boca Juniors, Ciudad Autónoma de Buenos Aires, Buenos Aires, ARGENTINA
FDA Status Not Applicable
Summary: Comparison of ACL isometric vs anatomic reconstruction and MRI images
and purpose: The aim of this retrospective study was to compare the clinical results after arthroscopic anterior cruciate ligament (ACL) reconstruction in professional soccer players and, the MRI`s image in terms of continuity, signal and obliquity of the new ACL in the sagittal plane.
We performed, between 2003 and 2013, 123 ACL reconstructions in professional soccer players, median age 29.69 (16-31), with patellar tendon graft but only 76 completed the required follow up and evaluation form by different circumstances.
The patients were divided in 2 groups: group A, anatomical ACL reconstruction (N=38) and group B, Isometric ACL reconstruction (Transtibial) (N=38). The groups were comparable in terms of age, gender, rehabilitation protocol and activity level. The median follow-up period was 34 months (range 24 to 48 months) in group A and 38 months (28 to 52 months) in group B (non significant difference) and was performed by independent observers.
At the end of the follow-up, there was no significant difference either in terms of the Lysholm score, which was 92.89 (65-100) and 95.57(70-100) points in group A and group B, respectively. Or using the IKDC evaluation system, 25 patients (65.78 %) were classified as normal, 11(28.94%) as nearly normal, 1 (2.63%) as abnormal and, 1 (2.63 %) as severely abnormal in group A, compared with 22 (57.89%) normal, 11 (28.94 %) nearly normal, 3 (7.89 %) abnormal, and 2 (5.26 %) severely abnormal in group B.
The KT-1000 measurement showed an anterior side-to-side laxity difference of 1.63 mm (0 to 11 mm) in group A and 1.92 mm (0 to 12 mm) in group B which was also a non-significant difference.
A significant difference was observed between groups at the image of the MRI, where, 28 were classified as "like normal" ?(A) with an homogeneous ligament signal, 9 heterogeneous signal but continuous new ligament (B) and 1 rupture (C) in group A; compared with Group B were 23 MRI were classified (A), 9 (B) y 6 (C) (p< 0.05)
A significant difference was also found in the inclination angle of the new ligament in the sagittal plane; 60.28º (48-66) in Group A versus 65.89º (54-78) in Group B (p<0.005).
Both techniques presented good results, not displaying significant differences between both in our casuistry. The angle and the MRI signal of the graft resemble the native ACL in the anatomical reconstructions. The anatomic reconstruction patients were subjectively more pleased with the results than isometric reconstruction patients. There were no differences in either early or late complications between the two groups. Regarding the evaluation and comparison of the rupture and degeneration of the knees, we believe that a longer follow-up will be needed (5 or 10 years).