چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| امیر محمد نوالی | اول |
| عنوان | متن |
|---|---|
| کلمات کلیدی | maneuver, ACL , reconstruction |
| خلاصه مقاله | Objectives: In an ACL deficient knee the tibia is internally rotated and displaced anteriorly. This abnormal anterior location of tibia relative to the femur causes PCL kinking and laxation by approximating its origin and insertion. In case of ACL graft fixation in an anteriorly displaced tibia, the desired tibiofemoral stability will not be achieved and a persistent anterior translation of tibia will ensue. The presence of PCL buckling in the post-surgery MRI is the result of the failed tibial reduction in ACL surgery. We hypothesized that for obtaining optimal results in ACL reconstruction surgery, tibia should be reduced before graft fixation. Our proposed maneuver reduces tibia to its anatomic location by exerting posterior and external rotational force. This Maneuver is exerted during final ACL graft fixation. The purpose of this study is to assess the efficacy of this maneuver. Methods: In a prospective cohort study from Nov 2011 to Oct 2013, 457 patients with ACl reconstruction were enrolled. In 224 cases, the ACL graft was fixed in a standard fashion with traction applied on the graft. In the remaining 233 cases, we used a maneuver to reduce the joint prior to final graft fixation. Anatomic single bundle ACL reconstruction using quadruple hamstring graft were done in all cases. The mean follow up was 29 months (24–38 months). Lysholm, IKDC, modified Cincinnati, Tegner-Lysholm activity scores and pivot shift test were recorded prior to surgery and at the final follow up. The anterior translation of tibia was measured using KT 1000 and a motorize arthrometer. The results were statistically analyzed at the final follow-up. Results: Despite a slightly better results in the final Lysholm, IKDC, modified Cincinnati and Tegner-Lysholm activity scores there were no significant differences between two groups, but the anterior translation of tibia measured by KT 1000 and the motorized arthrometer was significantly lower in the maneuver-exerted group. The mean KT-1000 arthrometer side-to-side difference was 3.6 mm for the standard group and 1.5 mm for the maneuver group. The mean motorized arthrometer side-to-side difference was 4.1 mm for the standard group and 2.1 mm for the maneuver group. The clinical pivot shift test (0–3) showed significant better results in the maneuver group. Conclusions: According to our results, we concluded that the use of our proposed maneuver during ACL reconstruction surgery could improve final results by reducing tibia to its anatomic location. |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| N.1.pdf | 1399/02/04 | 59547 | دانلود |
| 1.jpg | 1399/02/04 | 125293 | دانلود |
