Reconstruction of the Anterior Cruciate Ligament by Patellar Tendon and Artificial Trevira ligament: Comparison between mini-arthrotomic and arthroscopic technique

Tae, Suk Kee; Jung, Yung Bok; Park, Yong Jun

Abstract

Rupture of the anterior cruciate ligament is a serious injury that can cause severe degenerative change if untreated, and there are many controversies in its treatment. The authors experienced 126 patients of the anterior cruciate ligament rupture in the Department of Orthpaedic Surgery, Chung-Ang university from May 1985 to December 1992. Among them, we performed 36 anterior cruciate ligament reconstructions using bone-patellar tendon-bone autograft reinforced with Trevira ligament, an assumption that the artificial ligament acts as an internal splint during the vulnerable period of healing. Bone-patellar tendon-bone autograft was passed through the transosseous hole in the tibia, then across the knee and through the isometric path of lateral femoral condyle through a bone tunnel. Thereafter, the Trevira ligament was passed through the same tibial tunnel, but over the top route to the lateral femoral condyle. Of the 36 cases, 28patients (Group I: 15 cases of Mini-arthrotomy,Group II: 13 cases of Arthroscopic technique) with average follow up of 23.5 months (minimum 12 months, maximum 40 months) were analyzed. According to the Mullers criteria, the result were excellent in 12 cases (Group I: 5 cases; Group II: 7 cases), good in 14 cases(Group I: 9 cases ; Group II: 5 cases and fair in 2 cases (Group I: 1 case; Group II: 1 case). On stress roentgenograms by Telos arthrometer, the average difference of anterior displacement between the injured and normal sides were decreased to 2.3mm from average 9.1mm preoperatively (Group I: from 9.3mm to 2.6mm; Group II: from 8.8mm to 2.1mm). And subjectively, there was no difference between the injured and normal sides in 8 cases (Group I: 4 cases, Gruop II: 4 cases).