The Comparative Study of the Clinical Efficacy of Different Fixation Methods at the Tibial End of Single Bundle Anterior Cruciate Ligament Reconstruction under Arthroscopy
Objective:To compare and analyze the clinical efficacy of rotator cuff screw combined with interfacial extrusion screw fixation and self-made door screw combined with interfacial extrusion screw fixation at the tibial end of single bun-dle anterior cruciate ligament reconstruction under arthro-scopy.Methods:The clinical data of 60 patients who completed single bundle anterior cruciate ligament recon-struction from January 2021 to January 2023 were retrospec-tively analyzed.All grafts were made of autologous hamstring tendons.The femoral ends were suspended and fixed by Endobutton.The tibial end:30 cases were fixed with rotator cuff outer row screw combined with interface extrusion screw as the observation group,and the remaining 30 cases were fixed with self-made door screw combined with interface extrusion screw as the control group.The two groups of patients underwent the same functional rehabilitation training after operation.The clinical efficacy was evaluated by comparing and analyzing the operation time,functional rehabilitation and magnetic resonance imaging(MRI)examination data of the two groups.Results:All patients were followed up 12-36 months(mean 18.5 months).The operation time was(56.73±10.37)min in the observation group and(55.23±11.57)min in the control group,and the difference was not statistically significant(P＞0.05).Functional rehabilitation:Compared with preoperative,the international knee documentation com-mittee(IKDC)scores and Lysholm scores of the two groups were significantly improved at 3,6,and 12 months after oper-ation(P＜0.05).There was no significant difference in IKDC score and Lysholm score between the two groups at the cor-responding time points of 3,6,and 12 months after operation(P＞0.05).MRI evaluation:the tibial tunnel was enlarged in both groups after operation,the enlargement of tibial tunnel increased significantly in the two groups at 3,6,and 12 months after operation with the passage of time(P＜0.05),and the observation group was significantly smaller than that in the control group at corresponding time points(P＜0.05);At 3,6,and 12 months after operation,T2 value of tendon-bone junction,signal intensity and signal-to-noise ratio of graft were significantly decreased in the two groups(P＜0.05),and the observation group was significantly smaller than that in the control group at corresponding time points(P＜0.05).Conclusion:The different double fixation methods at the tibial end of anterior cruciate ligament reconstruction under knee arthroscopy have similar operation time and functional recovery of knee joint.However,the rotator cuff screw combined with interfacial extrusion screw fixation has little influence on the enlargement of tibial tunnel,and the interference of in-ternal fixators is less,which is more conducive to the reconstruction of tendon and bone healing of the graft,and can avoid the removal of the self-made door screw by a second operation.
knee jointanterior cruciate ligament reconstructionarthroscopyrotator cuff screwself-made door screw
万方数据
维普
