Abstract

CALETA, Esteban J.. Resultados de la reconstrucción artroscópica del ligamento cruzado anterior mediante injerto de isquiotibiales y fijación cortical. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.1, pp.57-72. ISSN 1852-7434.

Background: To evaluate retrospectively the results obtained using ST-RI double graft and cortical femoral and tibial fixation. The fixation system used in a reconstruction of anterior cruciate ligament (ACL) must be strong, secure and rigid to prevent breakage, displacement and sliding of the graft and keep it within the bone tunnels until histology incorporation to the bone during the cyclic loads in the postoperative rehabilitation period. The graft of semitendinosus and gracilis tendons (ST-RI) double failed in the past, not of its strength but for its attachment. Methods: Between January 2006 and December 2008 were 39 ACL reconstructed in 39 patients, 90.6% athletes, with ST-RI double and cortical fixation with accelerated rehabilitation protocol without braces or crutches. Patients were evaluated with IKDC subjective and objective tests, Lisholm, Tagner, KT-1000, Pivot Shift, IKDC score and radiological behavior of the bone tunnels. It also analyzed the type of activity, associated injuries, the return time to the sports, outcomes in workers compensation´s patients and complications. Results: Seven patients were excluded by exclusion criterias or did not return to this evaluation. It was evaluated 32 procedures in 32 patients, average follow-up two years. One case suffered severe stretching of the graft, probably by trauma, should be revisioned and consider as failure. The test was 98/100 Pts Lysholm and IKDC subjective average of 97/100 Pts; the KT1000 displacement was 2 mm and 80.6% had A and B knees. Three patients (10%) decreased Tegner level. In 54.8% of the Rx front and profile was not evidenced pathological widening of the tunnels. The best results were seen in patients who were authorized to return to sports activities at 6 months postoperatively, those which did not have workers' compensation (CL), younger that 30 years, no meniscal injuries and operated on before 3 months of the injury. Conclusions: The cortical fixation promotes good subjective and objective clinical results, rapid return to work activity and / or sports and high patient satisfaction in acute, chronic, athletes and workers' compensation patients.

Keywords : Knee; Ligament injuries; Reconstruction; Anterior cruciate ligament; Cortical fixation; Graftç hamstrings; Semitendinosus; Gracilis; Accelerated rehabilitation.

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