Comparison of short-term curative effects between three fixations of the tibial end in reconstruction of the anterior cruciate ligament
10.3760/cma.j.cn115530-20230203-00066
- VernacularTitle:前交叉韧带重建术中胫骨端三种固定方式的近期疗效比较
- Author:
Zhao TANG
1
;
Hui JIANG
;
Jia MENG
;
Xiaojiang YANG
;
Tao YUAN
;
Yan LI
;
Nirong BAO
Author Information
1. 南京医科大学金陵临床医学院（东部战区总医院）骨科，南京 210002
- Keywords:
Anterior cruciate ligament;
Arthroscopy;
Tibia;
Interface screws;
Rivets;
Portal nails
- From:
Chinese Journal of Orthopaedic Trauma
2023;25(10):897-901
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the short-term curative effects between 3 fixations of the tibial end with an interface screw, an interface screw + a portal nail and an interface screw + a knotless rivet in reconstruction of the anterior cruciate ligament (ACL).Methods:A retrospective study was conducted to analyze the data of 150 patients who had undergone reconstruction surgery for ACL injury at Department of Orthopaedics, Jinling Clinical Medical College, Nanjing Medical University from January 2019 to December 2021. The patients were divided into 3 groups according to their different fixations of the tibial end. In group A of 51 cases subjected to fixation of the tibial end with an interface screw, there were 40 males and 11 females with a mean age of (29.8±10.6) years. In group B of 55 cases whose tibial end was fixated with an interface screw + a portal nail, there were 47 males and 8 females with a mean age of (28.6±6.9) years. In group C of 44 cases whose tibial end was fixated with an interface screw + a knotless rivet, there were 39 males and 5 females with a mean age of (28.6±8.1) years. The 3 groups were compared in terms of International Knee Documentation Committee (IKDC) scoring and Lysholm knee function scoring at 12 and 48 weeks after operation, incidence of local pain at 4 weeks after operation, and stability of the knee at 48 weeks after operation.Results:There was no significant difference in the preoperative general data or follow-up time between the 3 groups, indicating comparability ( P>0.05). At 12 weeks after surgery, in Group B and Group C, the IKDC scores [(74.27±3.32) and (76.48±3.83) points] and Lysholm knee joint scores [(77.65±3.14) and (79.75±5.39) points] were significantly better than those in Group A [(69.73±6.04) and (71.63±3.36) points] ( P<0.05). However, there was no statistically significant difference in the above scores among the 3 groups at 48 weeks after surgery ( P>0.05). The incidence of local pain at the tibial end in group B (9.1%, 5/55) was significantly higher than that in group A (0, 0/51) and group C (2.3%, 1/44) at 4 weeks after surgery, and the results of the anterior drawer test in group A (36 negative cases, 14 cases of grade Ⅰ, and 1 case of grade Ⅱ) were significantly worse than those in group B (50 negative cases, and 5 cases of grade Ⅰ) and group C (40 negative cases, and 4 cases of grade Ⅰ) at 48 weeks after surgery ( P<0.05). Conclusions:In ACL reconstruction, all the 3 fixations of the tibial end can achieve fine short-term curative effects. Fixation with an interface screw + a knotless rivet may lead to a lower rate of ligament relaxation and a higher score of early knee function than fixation with an interface screw, and a lower incidence of local pain at the tibial end than fixation with an interface screw + a portal nail.
