Arthroscopic reconstruction of anterior cruciate ligament with the tibial remnant tendon and gracilis tendon autograft

Abstract

Objective To introduce an operative method for anterior cruciate ligament (ACL) reconstruction by using the gracilis tendon autograft and the tibial remnant tendon.Methods From April 2003 to May 2008,40 patients,22 males and 18 females,underwent ACL reconstruction only with gracilis tendon autograft while the remnants of tibial ACL tendon were preserved.They had an average age of 30.7 (17 to 43) years.There were 33 cases of acute injury and 7 cases of old injury.Intervals from injury to operation averaged 3.4 (1 to 12) weeks.We determined the mean length of gracilis tendon and the mean diameter and length of graft tendon.We compared the pre- and postoperative values of the anteroposterior laxity with the KT-2000 arthrometer,the bilateral postoperative ranges of motion,and the bilateral knee flexor torques 6,12 and 24 months after surgery with BIODEX,as well as the IKDC scores before and after surgery.Results The mean length of harvested gracilis tendon was 239 ram,and the mean diameter and length of the graft tendon folded into 5 strands were 7.6 mm and 41.4 ram respectively.There was no postoperative difference in range of motion between the suffered and healthy knees.The preoperative values of anteropesterior laxity evaluated with the KT-2000 arthrometer averaged 5.0 mm,and the postoperative values averaged 1.0 mm.The average postoperative knee flexor torques of 60°/s was 89% at 6 months,92% at 12 months and 95% at 2 years.The average postoperative knee flexor torques of 90°/s was 85% at 6 months,86% at 12 months and 89% at 2 years.The average IKDC score was 49.3 points preoperatively and 95.0 minutes 2 years postoperatively.There was a significant difference between the average preoperative VAS score (30.3) and the postoperative one (85.4) (P＜0.05) .Conclusions The ACL reconstruction can be done with gracilis tendon autograft and the tibial remnant tendon.The ACL remnants can be preserved as a source of reinnervation and regeneration of blood circulation to benefit the patient. Key words: Anterior cruciate ligament; Muscle,skeletal; Tendons; Arthroscopy