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Early curative effect of anatomical reconstruction by retaining anterior cruciate ligament residual end under arthroscopy

WANG Hui,SHEN Jian-ping,ZOU Hong,et al.Dpeartment of Joint Surgery,Mianyang Orthopaedic Hospital,Mianyang 621000,China  
Objective To explore the curative effect of anatomical reconstruction by retaining the anterior cruciate ligament(ACL) residual end under the arthroscopy.Methods From Aug.2010 to Feb.2012,43 patients with ACL damage were treated,including 29 males and 14 females who were aged from 21 to 60 years old(mean 36.7).ACL was reconstructed with 4-5 femoral graciles and the half tendon single beam.The femoral head was subject to the Endo-button suspension fixation.The tibial end was fastened by using the tied pile and extruded screw.Results All 43 patients were followed up for 6 to 24 months.The average range of motion recovered to 90 degrees during 10 weeks after surgery,with more than 120 degrees,and 0 degree extension at 4th postoperative month.Lysholm knee function scores were increased from 23.6 to 91.3 points.Forty patients were reexamined with Lachman test(-),neutral and internal and external rotation ADT(-),the pivot shift test(-);3 patients were reexamined by ADT(+),with the advancement of less than 5 mm.The X-ray showed satisfaction of the bone tunnel healing satisfaction.Conclusion The anatomic reconstruction by retaining the ACL stump under the Arthroscopy is more advantageous to the knee recovery of the rotation stability.Meanwhile,It is not only effective to retain the ligament stump reconstruction,but also conducive to the promotion of the reconstructed ligament revascularization.The retention of stump and the observation of the positioning points acquire a higher technique.Otherwise the loss outweighs the gain.The joint stability of early follow-up is favorable,and the long-term results need a further observation.
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