Short-term functional outcomes of anatomic single-bundle ACL reconstruction using modified I.D.E.A.L technique

Barham M. Rasul, R. M. N. Fatah
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Abstract

To achieve a satisfactory knee function and successful return to sports activities in patients with an ACL injury, it is essential to accurately reproduce the native ligament anatomy and biomechanics by placing the graft in the anatomical position within the ACL footprint. Our objectives are to investigate the short-term functional outcomes of an anatomic single-bundle reconstruction using the modified I.D.E.A.L technique of femoral tunnel placement, with 1-year follow-up.A retrospective observational study of 120 patients who developed ACL rupture and underwent anatomic single-bundle reconstruction in TUY MALIK private hospital/ Sulaymaniyah city/Iraq from March 2020 till March 2022. The functional outcomes of the procedure were assessed using the subjective knee evaluation scores (IKDC, Lysholm, and Tegner scores) preoperative and 1-year postoperatively. The mean preoperative IKDC score was 50.96 (40.22- 60.91), and 1-year postoperative score was 83.81 (72.41-95.40), with a (p-value 0.000), whereas the mean Lysholm score was 51.17 (40-67) and 86.19 (75-95) preoperative and postoperative, respectively, with a (p-value 0.000). The mean Tegner score was 7.59 preinjury, while 3.63 before the operation and 7.18 after the operation with (p-value 0.000), representing a statistically significant enhancement in functional outcomes between preoperative and final clinical follow-up assessment.Reconstructing ACL anatomically by placing the graft in the modified I.D.E.A.L position within the native femoral footprint can reestablish near-normal knee biomechanics, obtain unrestricted knee range of motion, and successful return to preinjury activity level.
改良I.D.E.A.L技术解剖单束ACL重建的短期功能结果
达到一个令人满意的膝盖函数成功返回ACL损伤患者的体育活动,有必要准确地复制本机韧带将移植解剖学和生物力学的解剖位置在ACL足迹。我们的目的是研究采用改良的ide.a.l股骨隧道置入术解剖单束重建的短期功能结果,并进行1年随访。回顾性观察研究了2020年3月至2022年3月在伊拉克苏莱曼尼亚市TUY MALIK私立医院进行的120例前交叉韧带破裂并进行解剖单束重建的患者。术前和术后1年使用主观膝关节评估评分(IKDC, Lysholm和Tegner评分)评估手术的功能结果。术前IKDC评分平均值为50.96(40.22 ~ 60.91),术后1年评分为83.81 (72.41 ~ 95.40),p值为0.000;术前Lysholm评分平均值为51.17(40 ~ 67),术后1年Lysholm评分平均值为86.19 (75 ~ 95),p值为0.000。损伤前Tegner评分平均为7.59分,术前为3.63分,术后为7.18分,p值为0.000,术前与最终临床随访功能评分相比有统计学意义的提高。解剖重建前交叉韧带,将移植物置于改良后的I.D.E.A.L位置,在原股足迹内,可以重建接近正常的膝关节生物力学,获得不受限制的膝关节活动范围,并成功恢复到损伤前的活动水平。
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