DIFFICULTIES IN ARTHROSCOPIC RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT USING M. SEMITENTINOSUS TENDON WITH ENDOBUTTON FIXATION – SIX YEAR EXPERIENCES
Authors:
Radim Kalina; Radomír Holibka; Miroslav Pach
Authors place of work:
Department of Ortopaedic Surgery, Faculty Hospital
and Medicine Faculty of the Palacky University Olomouc
; Klinika ortopedické chirurgie FN Olomouc
Published in the journal:
Úraz chir. 14., 2006, č.3
Summary
Purpose of the study:
The purpose of the study is to present the operating technique of the reconstruction of the anterior cruciate ligament using hamstrings with Endobutton position, to emphasise the difficulties of particular steps, to summarise the advantages and disadvantages of this technique and to discuss the issue of graft and fixation type selection in ACL reconstruction.
Materials and methods:
At the Department of Orthopedic Surgery of the Faculty Hospital Olomouc, 1464 patients underwent reconstruction of the ACL with Endobutton position between January 1999 and September 2005.
Discussion:
The disadvantage of the Endobutton technique is the extraarticular indirect fixation and its negative effects („bungee and windshield – wiper effect“). The selection of graft in ACL reconstruction depends on the surgeon’s experince, accessibility of the graft and on the patient’s activity. The patellar ligament is generaly used in active and professional athletes. Hamstrings are used in older people, women and recreational athletes.
Every type of graft fixation has its advantages and disadvantages. An ideal solution is hybrid fixation, which supports the biological healing of the graft and also provides sufficient primary mechanical strength.
Conclusion:
Endobutton technique belongs to the more difficult operating techniques of ACL reconstruction. Most important for its success are correct indication, precise performance of the technique with focus on canal centration and graft presfit, patient’s compliance and correct rehabilitation.
Key words:
arthroscopy, anterior cruciate ligament, m. semitendinosus, Endobutton position.
Zdroje
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