ADVANTAGES AND FEATURES OF ARTHROSCOPIC REINSERTION OF THE ANTERIOR CRUCIATE LIGAMENT OF THE KNEE JOINT WITH INTERNAL SPLINTING (internal brace technology)

Abstract

Background. Despite the annual increase in the number of patients with knee injuries, there is no gen-erally accepted algorithm for treating patients with anterior cruciate ligament injury (ACL). Conservative treatment is ineffective, as in 75-87% gives chronic anterior medial instability, increases the risk of post-traumatic arthritis by 51,2%. There is a considerable interest in arthroscopic primary recovery of ACL. The aim of the study is to evaluate the results of treatment of patients with ACL rapture and to develop a differentiated approach in its treatment. Materials and methods. The results of treatment of patients with ACl rupture who underwent ligament reinsertion (n = 40) and ACL reconstruction (n = 50) were analyzed. The assessment was performed on the scale of VAS for 2 days, VAS and IKDC 2-6-12 weeks after surgery Results. On the second day after the ligament reinsertion, patients had less pain compared to their post-reconstruction sensations: VAS 4,1 versus 5,3. In the group of patients after reinsertion of ACL in the period of 2-6 weeks there were lower rates of pain, namely 2,25 compared with 3,4 in the group of ACL reconstruction. At 2 weeks after reinsertion, patients reported moderate pain and an activity level of 66,4 ± 3,5 compared with the 61,3 ± 2,6 ligament reconstruction group on the IKDC scale. At 6 weeks, the positive dynamics persists, 80,2 ± 2,8 and 76,9 ± 3,1 IKDC, respectively. In 12 weeks, patients in both groups recover almost completely and return to daily activity, 93,9 ± 3,6 and 91,7 ± 2,4 on the IKDC scale, respectively. Conclusions. Primary recovery for proximal ACL ruptures shows good results and may be an alternative to ACL reconstruction. Success is based on the location of the ligament rupture and the tissues quality. The possibility of the initial ACL recovery is solved during surgery. If there is any doubt about the suitability of tissues for recovery, it is recommended to perform a standard reconstruction of ACL.