بازسازي رباط متقاطع قدامي زانو با استفاده از رباطهاي هام استرينگ و ثابت كننده پيچ و اثر خاردار

HAMSTRING A.C.L RECONSTRUCTION AND A.O SCREW AND SPIKED WASHER FIXATION

Fifty consecutive patients with ACL deficiency and inability to do sports and daily activities underwent endoscopic ACL reconstruction with a four strands of hamstring tendon. After completion of a brace free, intensive rehabilitaion in a prospective study we analysed the results. The graft was placed arthroscopically without impingement by the intercondylar roof and was fixed within the tibial tunnel to conserve the length of the graft for the Fixation by A.O screw and spiked washer to the supracondyle of femure. After 6 months the patients returned to unrestricted sports and daily activities. Clinical evaluation performed using the IKDC scoring system. Forty-six patients (92%) considered their knee function normal or near normal. Thirty-one patients (62%) return to their preinjury activity level. One leg hop were more than %90 of opposite side in 24 patients (%48) and more than %76 in 16 patients (%32). In ligament examination group of IKDC, 8 patients (%16) were graded A and 38 patients (%76) graded B. In overall IKDC assassment 45 (%90) were considered normal or nearly normal. Knee function, and return to preinjury activity level had no correlation with ligamnt examination tests (X2=3.19, P>0.05) (X2=1.64, P>0.05), but had a significant correlation with IKDC score (X2=21.42, P<0.001), (X2=19.8, P<0.001) Return to preinjury activity level had a significant correlation with one leg hop (X2=19.8, P<0.001). These results indicate that endoscopic ACL reconstruction using four strands of hamstrig tendon graft and AO screw and spiked washer fixation achieves acceptable knee stability and function, with a high rate of return to preinjury activity level. Knee function mostly correlated to one leg hope and IKDC score, and return to preinjury activites have significant relationship with IKDC score.