Сравнение результатов восстановления передней крестообразной связки коленного сустава с использованием аутотрансплантата из сухожилия длинной малоберцовой мышцы и из связки надколенника с двумя костными блоками

Abstract

Introduction Growing knowledge and understanding of the biomechanics and kinematics of the knee are prompting the search for new surgical techniques and new ACL grafts. Purpose Evaluation of the medium-term results of primary arthroscopic reconstruction of the anterior cruciate ligament of the knee using peroneus longus tendon autograft and comparing the results with the control group of patients who underwent primary arthroscopic reconstruction of the anterior cruciate ligament using patellar tendon autograft with two bone blocks. Materials and methods 108 patients were operated on in 2017-2018. They were divided into two groups. 55 patients underwent reconstruction of ACL using peroneus longus ligament autograft – group 1 (study group). 53 patients underwent reconstruction of ACL using patella tendon autograft – group 2 (control group). Evaluation of the knee joint function was based on clinical examination, medical history, results of functional tests, MRI results, on the data of instrumental diagnostic methods (CT‑1000) after the surgical treatment, patient responses when filling out scales before surgery and two years after the surgery (Tegner Lysholm, IKDC). Additionally, the patients of the study group underwent a study on a plantograph before surgery and 24 months after it. Postoperative evaluation was also performed using the AOFAS scale. Results In group 1, the average score on the Tegner Lysholm scale before surgery was 69.2 ± 10.7 points, after surgery – 92.2 ± 10.4 points; on the IKDC scale before surgery – 68.2 ± 10.6 %, after surgery – 90.1 ± 9.5 %. KT-1000 – 3.7 ± 1.4 mm, AOSAF – 95.3 ± 7.5 %. An autograft rupture within 2 years after the surgery was detected in 4 out of 50 patients, which amounted to 8 %. Measurements on the PKS-01 plantograph 24 months after the operation did not reveal changes in the arch of the foot. In group 2, the average score on the Tegner Lysholm scale before surgery was 70.2 ± 11.6 points, after surgery it was 94.3 ± 8.7 points. The mean value on the IKDC scale before surgery was 68.6 ± 8.7 %, after surgery it was 91.5 ± 8.2 %. KT-1000 – 3.4 ± 1.2 mm. Autograft rupture within 2 years after the surgery was detected in 3 out of 50 patients, which amounted to 6 %. Conclusion The results of the operations performed in the two groups can be assessed as good, no statistically significant differences were found, which indicates that the peroneus longus tendon autograft is an alternative option for primary ACL repair.