Clinical effects of arthroscopic anatomical anterior cruciate ligament reconstruction with direct insertion technique

Abstract

Objective To explore the operating methods and clinical effects of arthroscopic anatomical anterior cruciate ligament(ACL) reconstruction with direct insertion technique versus traditional method. Methods From January 2017 to December 2017, totally 52 patients who accepted ACL reconstruction and met the inclusion and exclusion criteria in Beijing Friendship Hospital of Capital Medical University were enrolled in this retrospective study. They were divided into two groups by random sequence software and patients′ selection results. The observation group(27 cases) received direct insertion technique, and the control group(25 cases) received traditional method. At postoperative 1 month, 3 months, 6 months, 1 year, the clinical effect was evaluated by imaging index, subjective and objective indicators. Results All 52 patients were available for follow up with an average of 11.5 months. No postoperative complications such as infection, joint instability and soft legs, with a satisfied recovery of range of motion, pain relieved significantly. The Lysholm score of the observation group was (94.80±4.18)points, which was significantly higher than (91.02±1.96)points of the control group (t=2.674, P 0.05), but the pivot-test of the observation group was better than that of the control group, the difference was statistically significant (P<0.05). The ACL angle of the observation group was (51.52±5.18)°, which was significantly lower than (55.86±2.45)° of the control group (P<0.05). According to modified Lysholm scores classification, in the observation group, 24 cases were excellent, 2 cases were good, 1 case was fair, and the excellent and good rate was 96.3%. In control group, 18 cases were excellent, 5 cases were good, 2 cases were fair, and the excellent and good rate was 92.0%. The difference in the excellent and good rate between the two groups was statistically significant(P<0.05). Conclusion Direct insertion anatomical reconstruction is a safe and effective technique for reconstruction of ACL. It can restore the stability of ACL and rotation of knee joint. Key words: Knee injuries; Anterior cruciate ligament; Arthroscopy; Anatomic reconstruction; Joint instability; Comparative effectiveness research