15.
Increasing laxity after ACL reconstruction with patella tendon is not
caused by failure of fixation - a 10-year follow up with RSA
Louise Irdal-Jeppesen, Annette Holm Kourakis, Michael Rindom Krogsgaard
Section for Sportstraumatology M51 Bispebjerg University Hospital; Section
for Sportstraumatology M51, Bispebjerg University Hospital; Section for
Sportstraumatology M51, Bispebjerg University Hospital
Background:
Anterior cruciate ligament (ACL) rupture is a common injury,
that often leads to symptomatic knee instability, which can be treated with
reconstruction. The stability of the knee after reconstruction decreases during
the first postoperative year in at least 15 % of cases. Whether this is due to
stretching of tendon tissue or failure of the graftfixation to bone is unknown.
Purpose / Aim of Study:
To investigate if the bone-plugs in patella tendon
graft ACL reconstruction move relative to femur/tibia after the operation and if
there is any difference in this between metal- and bio-screw fixation.
Materials and Methods:
Prospective, one-centre, clinical trial, where 38
healthy patients (29,5±4,2 years) with symptomatic unilateral ACL rupture
which required reconstruction were blindly randomised [1:1] to fixation with
metal interference screw or bio screw (Bilok) in femur and tibia. During
surgery a total of 18 tantalum markers were placed in tibia (6), femur (6) and
the bone-plugs (3+3). By using Radio Stereometric Analysis (RSA) the precise
positions of the markers were measured. RSA was performed with the knee
bent 30 degrees and with 0, 7½ and 13 kg anterior pull at tibia. The patients
were followed 1 week and 1, 2 and 10 years after the operation.
Findings / Results:
In all patients, independent of increasing laxity, there was
no motion of the markers in the boneplugs relative to femur and tibia at any
time compared to 1 week.
Conclusions:
The laxity that developed postoperatively in some patients was
not due to failure of fixation.
Deltager i konkurrencen om YODA’s ungdomsforskerpris
