Analysis and countermeasure of intraoperative pitfalls in arthroscopic assisted anterior cruciate ligament re-construction
- VernacularTitle:关节镜下前十字韧带重建术术中失误原因的分析与对策
- Author:
Hao SHEN
;
Yao JIANG
;
Jinzhong ZHAO
- Publication Type:Journal Article
- Keywords:
Anterior cruciate ligament;
Arthroscopy;
Patellar ligament;
Tendon transfer
- From:
Chinese Journal of Orthopaedics
1999;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective Of all the knee ligament,the anterior cruciate was totally disrupted the most frequently.Although a high degree of success and satisfactory results of replacement of anterior cruciate liga-ment with autograft tendon by arthroscopy were demonstrated,the objective of the investigation was to retro-spectively analyze miscellaneous pitfalls in anterior cruciate ligament reconstruction procedure and present its treatment.Methods Between January1995and June2002,consecutive194male and female patients between thirteen and fifty-eight years of age who sought treatment for a chronic tear of the anterior cruciate ligament were treated by arthroscopic assisted anterior cruciate ligament reconstruction.The time-interval between the index injury and the surgery was from1.5to37months.The diagnosis of anterior cruciate liga-ment injury was established by Lachman test,pivot-shift examination and MRI.The procedures included au-tograft bone-patellar tendon-bone replacement fixed with Kurosaka interference screws in75cases,allograft bone-patellar tendon-bone with Kurosaka interference screws in13cases,autograft bone-patellar tendon-bone fixed with Aesculap Endobutton suture plates in11cases,allograft bone-patellar tendon-bone with Aesculap Endobutton suture plates in6cases,hamstring autografts fixed by Aesculap Endobutton suture plate in89cases.Results There were39intraoperative pitfalls happened in36cases,in which2intraop-erative complications were unsalvageable.The causes of pitfalls could be classified into tunnel,graft materi-als,fixation and other problems.The most common pitfalls were the mistakes of position and direction of guide wires for bone tunnel occurred in8cases.The interference screw was loosened in2cases.Bending of the guide wire happened in3cases.Short and bifurcated of harvested grafts were the most common problem in reconstruction with hamstring autografts and Aesculap Endobutton suture plate technique.In the present,there were no complications of patellar fracture and breakage of reconstructive materials.Conclusion A deep knowledge and technique are necessary to determine and perform in anterior cruciate ligament recon-struction procedure,only if mastering the essentials of different anterior cruciate ligament reconstruction methods and handling flexibly,could an orthopedist cope with miscellaneous pitfalls rightly.
