Evaluation of Long-term Outcome of Arthroscopic Reconstruction of Anterior Cruciate Ligament Injury by Hamstring quadrupled Auto graft fixed by Bio Screws in a tertiary level hospital

Pulse Pub Date : 2024-01-15 DOI:10.3329/pulse.v15i1.70904

Md Muztaba Ali, Md. Tanvir Rahman, Nazmee Kabir, Tamzid Billah, Tamam Rahman, Shihat Ahmed, Md. Sohel

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Abstract

Background: Hamstring tendon auto grafts in the form of quadrupled semitendinosus and gracilis (STG) has become an increasingly used alternative for anterior cruciate ligament (ACL) reconstruction. Bio screw avoids complications by decreasing possibility of graft damage. Current study was designed to evaluate arthroscopic ACL reconstruction with quadrupled semitendinosus auto graft and fixation of the graft by two biodegradable screws in both femur and tibia. Objectives: This study was conducted to evaluate the outcome of arthroscopic ACL reconstruction by semitendinosus tendon autograft using biodegradable screws for both tibia and femur. Methods: 300 patients with ACL injury admitted from January 2010 to December 2015 in the then Apollo Hospitals Dhaka (Evercare Hospital Dhaka now) were enrolled. All patients underwent ACL reconstruction surgery by quadrupled semitendinosus or gracilis auto graft fixed by Bio Screws. After discharge, these patients were followed up for 3 weeks, 3 months and final outcome was recorded after 6 years. Results: 270 patients (90%) had an uneventful post-operative period. 200 patients (66.67%) complained of postoperative pain after 3 weeks, 10 patients (3.33%) complained of knee swelling, 10 (3.33%) patients had infections & 20 patients (6.65%) had knee stiffness after 6 months. Postoperatively, Lachman test improved significantly, grade 0 in 93.33% cases (280 patients) and grade I was in 6.67% cases (20 patients). Anterior drawer test was also markedly improved. Grade 0 was in 93.33% cases (280 patients) and grade I was in 6.67% cases (20 patients). According to the Lysholm Knee Scoring, the final long-term outcome was excellent in 76.67% cases (230 patients), good in 20% cases (60 patients) and fair in 3.33% cases (10 patients). Conclusion: Arthroscopic reconstruction of ACL by quadrupled hamstring autograft fixed by biodegradable screws for both tibia and femur, leads good to excellent results in the majority of the cases. Pulse Vol.15, 2023 P: 9-15

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一家三级医院对用 Bio Screws 固定腘绳肌四倍自动移植体重建前交叉韧带损伤关节镜手术的长期效果评估

背景：半腱肌和腓肠肌（STG）四联腘绳肌腱自体移植已成为前十字韧带（ACL）重建术中越来越常用的替代方法。生物螺钉可降低移植物受损的可能性，从而避免并发症。本研究旨在评估关节镜下使用四股半腱肌自体移植物进行前交叉韧带重建，并在股骨和胫骨上使用两枚可降解螺钉固定移植物的效果。研究目的本研究旨在评估使用半腱肌腱自体移植物在胫骨和股骨进行关节镜前交叉韧带重建术并使用生物可降解螺钉固定移植物的效果。方法：选取 2010 年 1 月至 2015 年 12 月期间在当时的达卡阿波罗医院（现为达卡 Evercare 医院）住院的 300 名前交叉韧带损伤患者。所有患者都接受了前交叉韧带重建手术，采用四肢半腱肌或擒拿肌自体移植，并用生物螺钉固定。出院后，对这些患者进行了3周、3个月的随访，并记录了6年后的最终结果。结果：270 名患者（90%）术后恢复顺利。200 名患者（66.67%）在 3 周后抱怨术后疼痛，10 名患者（3.33%）抱怨膝关节肿胀，10 名患者（3.33%）出现感染，20 名患者（6.65%）在 6 个月后出现膝关节僵硬。术后，拉赫曼试验明显改善，93.33%的病例（280 名患者）为 0 级，6.67%的病例（20 名患者）为 I 级。前抽屉试验也有明显改善。93.33%的病例（280 名患者）为 0 级，6.67%的病例（20 名患者）为 I 级。根据 Lysholm 膝关节评分，76.67% 的病例（230 名患者）的最终长期疗效为 "优"，20% 的病例（60 名患者）为 "良"，3.33% 的病例（10 名患者）为 "一般"。结论在关节镜下用四股腘绳肌自体移植物重建前交叉韧带，并用生物可降解螺钉固定胫骨和股骨，在大多数病例中都能取得良好至卓越的疗效。脉搏》第 15 卷，2023 年，第 9-15 页

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