Objective To explore an improved reconstruction of the anterior crucial ligament (ACL) with the allograft hamstring fixed by the Rigidfix and Intrafix anchorages and to evaluate its therapeutic effectiveness in a short term. Methods The ACL reconstruction was performed under the arthroscope on 21 patients’ knees from Janaury 2006 to December 2006. There were 13 males and 8 females aged from 18 to 53 years. The injuries were caused by a traffic accident in 7 patients, a movement damage in 11, and other factors in 3. The medial collateral ligament(MCL) and the medial meniscus were injured in 10 patients, the medial meniscus andthe lateral meniscus were injured in 3, the lateral meniscus was injured in 6, and only the ACl was injured in 2. The operations were performed 7 days to 3 monhs after the injuries. The graft used was the fourstranded allograft hamstring, which was fixed by the Rigidfix and Intrafix anchorages. The therapeutic effect was evaluated according to the Lysholm rating scale. Results The follow-up of all the 21 patients for 3-9 months (average, 5.8 months) revealed that the knees of 19 patients could move beyond 120° after operation. In 1 patient who had the MCL injury, the range of genuflex was limited to 80° at 3 months after operation, and so the operation of lysis was performed under thearthroscope again. In 1 patient, the rejection against the allograft was treated by the irrigating under the arthroscope but had little effect. The anterior drawer test and the pivot shift test were negative in the 21 patients. During the Lanchman test, 1 patient had a positive result (Degree Ⅰ). The Lysholm scores were significantly increased from 56.73±6.58 to 88.14±7.02 (P＜0.01). Conclusion The surgical approach to reconstruction of ACL with the fourstranded allograft hamstring fixed by the Rigidfix and Intrafix anchorages is feasible and safe. The resulting fixation is reliable. The patients can begin their postoperative rehabilitation exercise earlier and their movement function can be restored earlier.
【Abstract】 Objective To explore the short-term cl inical effects on appl ication of absorbable RIGIDfix cross pinsand Intrafix screw for posterior cruciate l igament (PCL) reconstruction with autogenetic or xenogenic semitendinosus-plussemimembranosus tendons under arthroscope. Methods From June 2005 to January 2007, 36 cases of PCL injuries (including 20 fresh injuries and 16 old ones) were treated. There were 21 males and 15 females, aged 15-51 years old, mean 30.4 years. There were 19 cases in the left side and 17 cases in the right side. Thirteen cases out of them compl icated with medial collateral l igament injury; 9 cases compl icated with lateral collateral l igament injury; 2 cases compl icated with posterolateral structure injury; 11 cases compl icated with medial meniscus injury; 10 cases compl icated with lateral meniscus injury; 2 cases compl icated with nerve and vascular injury. PCL reconstruction was accompl ished by arthroscopy with autogenetic or xenogenic 4-strandsemitendinosus-plus-semimembranosus tendons. RIGIDfix cross pins were used for tibial side fixation, and Intrafix was used for femoral side fixation. Lysholm scores, international knee documentation(IKDC) grading and Lachman experiment were used for evaluation before operation and in the follow up. Results All the cases had been followed up for 6 to 26 months (average 10.4 months). IKDC grading showed that 3 patients (8.4 %) were graded as B, 12 patients (33.3%) as C, 21 patients (58.3%) as D before operation, while 9 patients (25 %) were graded as A, 21 patients (58.3%) as B, 6 patients (16.7%) as C after operation. Lysholm scores raised from 42.52 ± 5.24 before operation to 91.24 ± 5.68 after operation. Lachman experiment results showed that there were 5 cases（+）, 20 cases（++）and 11 cases(+++) before operation, while there were 2 cases（+） and 34 cases （-） after operation. Each index was significant between before and after surgery（P lt; 0.05）. After surgery, all the cases got good pain rel ief. Joint was stable, and motion range recovered. No pin and screw loosening was found. Only 4 cases sufferedfrom effusion and synovitis after surgery, and they were recovered after conservative treatment. Conclusion The method of using RIGIDfix-Intrafix complexes under arthroscopy for PCL reconstruction is simple and the fixation is rigid. Early functional exercise after operation is possible.