2017 ISAKOS Biennial Congress IFOSMA ePoster #5016

 

Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Infrapatellar Plicae:A Short-Term Follow-Up Study

Chengwu Zhao, Changchun, Jilin CHINA
Xiaonan Zhang, MD, Changchun, Jilin CHINA

the first hospital of JILIN university, changchun, jilin, china

FDA Status Not Applicable

Summary

Anterior cruciate ligament reconstruction is a popular surgery. But as for acute ACL tear with intact infrapatellar plicae patients, ACLR with Preserved Infrapatellar plicae whether or not give us some surprise in follow up study?

ePoster Not Provided

Abstract

Materials:
From September 1th,2015 to October 31th 2015, 27 patients of acute unilateral ACL tear with or without meniscus injury (less than 2 weeks),17 males, 10 females, average age 31.25ys(21-51ys). Methods : (1)Group : we define groups based on infrapatellar plicae whether or not intact,group A:12 cases, infrapatellar plicae is intact , group B:15 cases, infrapatellar plicae is injuried.(2) Surgery technique: All 27 patients ACLR use ipsilateral hamstring tendon with Endobutton femoral fixation and screw/spiked ligament tibial fixation. Meniscus tears sutured with fast-fix(gro Although ACL reconstruction has gained good clinical satisfaction , there are still some dissatisfaction feedback after ACLR postoperative review. Some authors believe ACLR with preserved the remnant of the ACL can bring better postoperative clinical satisfaction. They suggest that the remnant preserving technique could be an effective alternative considering its mechanical stability as well as the proprioception and vascularization recovery. Inspired by this idea , as for the infrapatellar plicae with the same ligament structure as ACL, it may also have normal or functional proprioception and vascularization. Because it hinders the observation and location of the microscopic ACLR view, we resect it as u up A 7,group B 8). Group A 12 patients , using 15# needle with PDS-II enter from medial-superior portal and reach under infrapatellar plicae, Enter to catch free end of PDS-II from medial-infra portal with arthroscopic view from medial-inferior portal. Catching PDS-II loop out from lateral-infra portal and lift up PDS-II and unfreeze view limited by infrapatellar plicae , make tunnel in tibial and femur as usual. Group B 15 patients, infrapatellar plicae is resected and others surgery technique is the same as group A.
(3) Postoperative evaluation and statistical analysis: It includes objective instability Lachman test, pivot test , Lysholm score, IKDC score,ROM, Berg Balance Scale, Floating patellar, Infrapatellar pain, Abnormal knocking. Post-op 4 months follow-up study , statistical analysis is assessed by SPSS 18.0 through Fisher X2 test/T-test/Wilcoxon test.Conclusion : There are a better satisfaction in the group with preserved infrapatellar plicae ACLR during short term post-operation follow-up. Patients suffered infrapatellar pain and abnormal knocking decrease , knee joint effusion quantity decreased significantly. So acute ACL tears patients with intact infrapatellar plicae , we can increase post-op satisfaction by surgery technique improved.