RESUMEN
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is the prevailing procedure in cases of ACL rupture. OBJECTIVES: To analyze ACL reconstruction based on time and costs of the surgery, postoperative pain, postoperative complications, time it takes to return to work or other such physical activity, and cosmetic effects. MATERIAL AND METHODS: The retrospective analysis involved 62 patients who had undergone ACL reconstruction with the same results in clinical and functional assessment, which were then divided into 2 groups. In one group, an allograft was utilized, while in the other group - an autograft. The time it takes to perform the surgery, the cost, pain expected to be experienced, the possibility of postoperative complications, scarring, and the time needed for return to work were all considered and analyzed. RESULTS: The surgery time was 40.64 ±4.23 min in group I in comparison to 52.48 ±4.92 min in group II (p < 0.05). The cost of surgery was 32% higher in group I. Visual analogue scale (VAS) pain score in group I was from 36.45 ±8.39 mm on the 3rd day to 15.16 ±5.70 mm on the 28th day. In group II, it ranged from 60.67 ±10.15 mm on the 3rd day (p < 0.05) to 18.67 ±6.81 mm on the 28th day. The time of return to office work in group I was 6.96 ±1.9 weeks and 9.27±1.57 weeks in group II (p < 0.05). The time of return to physical work in group I was 19.85 ±2.79 weeks, and 20 ±3 weeks in group II. Postoperative scar and local complications were statistically less pronounced in group I. CONCLUSIONS: Allografts achieve less postoperative pain, smaller local complications, shorter time necessary to return to work, and better cosmetic effect. However, an allograft is more expensive to perform.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Aloinjertos , Lesiones del Ligamento Cruzado Anterior/cirugía , Autoinjertos , Humanos , Estudios Retrospectivos , Trasplante Autólogo , Trasplante Homólogo , Resultado del TratamientoRESUMEN
BACKGROUND: The reconstruction of the anterior cruciate ligament (ACL) of the knee joint is the gold standard in complete ACL rupture treatment. One of the central discussion topics is choice of graft. OBJECTIVES: To assess the outcome of treatment after primary ACL reconstruction using allograft. MATERIAL AND METHODS: The study was a retrospective cohort study. Out of 372 male patients who had undergone primary unilateral intra-articular ACL reconstruction using strict inclusion and exclusion criteria, 61 patients who qualified for the study took part. Group I was made up of 31 patients with allograft, while Group II consisted of 30 patients involved with autograft. The Lachman test, Pivot-Shift test, Lysholm Knee Scoring scale, and 2000 International Knee Documentation Committee (IKDC) were used to evaluate the results. Follow-up time was 18 months. RESULTS: The knee joint regained anterior stability in subjective and objective assessments in all the patients in both groups. The subjective results were the following: in Group I, 96.6 ±3.08 points on the Lysholm scale and 94.79 ±6.53 points on the IKDC 2000 scale, while in Group II, 98.00 ±1.9 points on the Lysholm scale and 94.81 ±5.6 points on the IKDC 2000 scale. The group comparison of the results of the IKDC 2000 and Lysholm Scale obtained postoperatively showed no statistically significant differences between the 2 groups. CONCLUSIONS: Primary ACL reconstruction using an allograft is an effective procedure to counteract instability of the anterior knee joint. Comparative analysis of the results of primary ACL reconstruction in the treatment of anterior knee instability using autograft or allograft gives grounds for the possibility of individual selection of graft depending on what the patient's expectations are.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Aloinjertos , Ligamento Cruzado Anterior , Lesiones del Ligamento Cruzado Anterior/cirugía , Humanos , Articulación de la Rodilla , Masculino , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
BACKGROUND: One of the goals of the synthetic materials used in knee joint reconstruction of the anterior cruciate ligament (ACL) is to improve the strength and stability of the graft immediately after the reconstruction. One of the synthetic grafts is a non-absorbable synthetic ligament device made of terephthalic polyethylene polyester fibers, the Ligament Advanced Reinforcement System (LARS). OBJECTIVES: The aim of the study was to assess postoperative knee joint stability in patients who had undergone ACL reconstruction using the LARS graft. MATERIAL AND METHODS: The study group was comprised of 20 males who had undergone primary unilateral intraarticular ACL reconstruction using LARS. The patients were evaluated one day before the reconstruction and an average of six weeks postoperatively. Knee stability was evaluated manually using the Lachman test, anterior drawer test and pivot-shift test. Knee active range of motion (ROM) was measured. RESULTS: Preoperatively, the Lachman test indicated abnormal/2+ results in the vast majority of the patients. The postoperative results in most of the patients were normal/0. The anterior drawer test results were also abnormal/2+ preoperatively and normal/0 postoperatively. The pivot-shift test was positive in all of the patients before the ACL reconstruction and negative after the surgery. In general, no differences were found in the ROM between the involved and uninvolved limbs and in the between-measurement comparison. CONCLUSIONS: The evaluation demonstrated significant progress from the preoperative to postoperative results in reducing anterior translation and anterolateral rotational instability of the tibia in patients who had undergone ACL reconstruction using the synthetic LARS graft. In the short-term follow-up assessments, restoration of anterior and anterolateral rotational stability of the operated knee joints was observed.
Asunto(s)
Reconstrucción del Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/cirugía , Articulación de la Rodilla/cirugía , Ensayo de Materiales , Diseño de Prótesis , Adulto , Ligamento Cruzado Anterior/fisiopatología , Humanos , Articulación de la Rodilla/fisiopatología , Masculino , Ácidos Ftálicos , Poliésteres , Polietileno , Periodo Posoperatorio , Rango del Movimiento Articular , Resultado del TratamientoRESUMEN
Among the population over the age of 65 years joint diseases constitute more than 50% of chronic diseases and most often apply to the hip. Endoprosthetics is one of the methods for treating this condition and is considered one of the best--clinically and economically--interventions of the modern medicine. However, it is not free of complications among which the loosening of the endoprosthesis is commonest. In publications, a full discussion has been going on arguing whether the complication is caused by biological or mechanical factors. The authors--aiming to answer this question based on CT--tested the influence of the implantation of the acetabular component on the pelvic bone density in Hounsfield units within a 6-month period after the operation. The test results indicate the bone density decrease. The statistical analysis shows, however, that the changes are not statistically significant.