Objective To explore the effectiveness of arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction using six-strand autograft hamstring tendon plus TightRope suspension plate. Methods Between September 2014 and August 2015, 24 patients with ACL rupture accepted arthroscopic single-bundle ACL reconstruction using six-strand autograft hamstring tendon plus TightRope suspension plate. There were 16 males and 8 females with an age range of 18-54 years (mean, 36.2 years). The disease causes included sport injury in 15 cases, traffic accident injury in 4 cases, and sprain in 5 cases. The mean time from injury to operation was 3.9 months (range, 18 days to 8 months). The results of anterior drawer test, pivot shift test, and Lachman test were positive before operation. The preoperative International Knee Documentation Committee (IKDC) score was 38.69±3.85 and Lysholm knee functional score was 36.45±7.85. Results The incisions healed by first intention. No infection, deep vein thrombosis, or vessel and nerve injuries occurred. MRI showed the good tunnel position and ACL morphology. All patients were followed up 6-16 months with an average of 12 months. At last follow-up, Lysholm and IKDC scores were significantly increased to 81.31±7.58 and 79.62±5.39 respectively (P < 0.05). The results of anterior drawer test were negative in 17 cases and positive degree I in 7 cases; the results of Lachman test were negative in 20 cases and positive degree I in 4 cases; the results of pivot shift test were negative in 21 cases and positive degree I in 3 cases; and all showed significant differences compared with preoperative results (P < 0.05). Conclusion Arthroscopic single-bundle reconstrustion using six-strand autograft hamstring tendon plus TightRope suspension plate is a simple technique for ACL reconstruction, which can obtain satisfactory short-term effectiveness.
ObjectiveTo summarize the short-term effectiveness of TightRope system for the treatment of syndesmotic tibiofibular diastasis. MethodsBetween June 2013 and June 2015, 23 patients with syndesmotic tibiofibular diastasis were treated by TightRope system, including 15 males and 8 females with an average age of 32.3 years (range, 16-63 years). Injury was caused by sports in 13 cases, by traffic accident in 6 cases, and by falling from height in 4 cases. The locations were the left side in 13 cases and the right side in 10 cases. The time from injury to operation was 6 hours to 12 days (mean, 3.8 days). According to Lauge-Hansen classification, 13 cases were rated as supination-external rotation type, 7 cases as pronation-abduction type, and 3 cases as pronation-external rotation type; according to Weber classification, 5 cases were rated as type A, 11 cases as type B, and 7 cases as type C. ResultsThe mean operative time was 68.1 minutes (range, 48-93 minutes); the mean intraoperative blood loss was 70.3 mL (range, 20-150 mL); and the mean hospitalization days were 7 days (range, 5-13 days). Superficial local skin necrosis occurred in 6 cases, and primary healing of incision was obtained in the others. All patients were followed up 8-30 months (mean, 16.4 months). X-ray films showed bone union was achieved within 6-12 weeks (mean, 9.4 weeks). No related complications of reduction failure and re-fracture occurred. The internal fixators were removed at 10-18 months postoperatively (mean, 13.3 months). According to American Orthopaedic Foot and Ankle Society (AOFAS) score for ankle function evaluation, the results were excellent in 19 cases and good in 4 cases at last follow-up. ConclusionTightRope system is a good method to treat syndesmotic tibiofibular diastasis, because of safety, convenient operation, and satisfactory short-term effectiveness.
ObjectiveTo investigate the short-term effectiveness of arthroscopic single bundle four-strand reconstruction using autologous semitendinosus tendon and anterior half of peroneus longus tendon for posterior cruciate ligament (PCL) injuries.MethodsA clinical data of 30 patients with PCL injury, who were admitted between December 2015 and September 2018 and met the selection criteria, was retrospectively analyzed. All patients were treated with arthroscopic single bundle four-strand reconstruction using autologous semitendinosus tendon and anterior half of peroneus longus tendon and TightRope technique. Among them, 19 were male and 11 were female, aged 17-48 years (mean, 28.2 years). The PCL injury was caused by traffic accident in 8 cases, sport in 14 cases, falling and bruising by a heavy objective in 5 cases, and other injuries in 3 cases. The interval between injury and operation was 10-90 days (mean, 39.3 days). The PCL injury was rated as grade Ⅱ in 6 cases and grade Ⅲ in 24 cases. The posterior drawer test was positive in 26 cases and the inverse Lachman test was positive in 24 cases. The International Knee Documentation Committee (IKDC) score was 61.37±8.49, and the objective IKDC ligament grading was near normal in 2 cases, abnormal in 8 cases, and significantly abnormal in 20 cases. The modified Lysholm knee score was 62.20±5.67. The knee range of motion (ROM) was (101.83±8.15) °.ResultsThe operative time ranged from 70 to 110 minutes (mean, 79.7 minutes). All incisions healed by first intetion. All patients were followed up 12-24 months (mean, 19.0 months). There were 3 cases of deep vein thrombosis in the lower extremity after operation, and 1 case of approximately 10° limitation of knee extension. At last follow-up, the posterior drawer test was positive in 2 cases and the inverse Lachman test was positive in 1 case, with significant differences compared with the preoperative period (χ2=38.571, P=0.000; χ2=36.274, P=0.000). The IKDC score was 84.67±3.67, and the objective IKDC ligament grading was normal in 16 cases, nearly normal in 10 cases, abnormal in 3 cases, and significantly abnormal in 1 case; the modified Lysholm knee score was 90.37±4.49; all of the above indexes were significantly better than preoperative ones, and the differences were significant (t=−12.387, P=0.000; Z=−2.810, P=0.005; t=−22.865, P=0.000). Knee ROM was (88.33±9.86)° at 1 month after operation and reached (113.33±13.48)° at last follow-up, showing significant differences between pre- and post-operation (P<0.05). MRI re-examination showed that the form and position of reconstructed PCL were satisfactory.ConclusionIt can obtain good short-term effectiveness for PCL injuries by arthroscopic single bundle four-strand reconstruction using autologous semitendinosus tendon and anterior half of peroneus longus tendon, which has the advantages of reliable surgical approach, safe operation, and precise effectiveness.
Objective To study the effectiveness of TightRope elastic fixation combined with functional total repair of the inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury. Methods The clinical data of 34 patients with distal tibiofibular syndesmosis injury who met the selection criteria between January 2020 and January 2022 were retrospectively analyzed, and they were divided into improved group (TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament) and control group (distal tibiofibular screw fixation) according to the surgical methods, with 17 cases in each group. There was no significant difference in age, gender, body mass index, fracture type, and other baseline data between the two groups (P>0.05). The operation time, intraoperative blood loss, and complications were recorded in the two groups. The American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle metatarsal flexion and dorsal extension range of motion were used to evaluate the ankle function. The patient satisfaction survey was conducted at last follow-up. Results All 34 patients were followed up 8-20 months, with a median of 13 months. The operation time and intraoperative blood loss in the improved group were significantly longer than that in the control group (P<0.05). In the improved group, no infection or poor reduction occurred, and only 1 patient had TightRope knot reaction at 6 months after operation. In the control group, there were 2 cases of poor reduction, 1 case of lower tibiofibular screw rupture, and 1 case of subcutaneous infection (cured after anti-infection treatment). There was no significant difference in the incidence of complications between the two groups (P>0.05). At last follow-up, the AOFAS score and ankle metatarsal flexion and dorsal extension range of motion of the improved group were significantly better than those of the control group (P<0.05). The satisfaction rates of patients in the improved group and the control group were 94.1% and 82.4%, respectively, showing significant difference (P<0.05). Conclusion TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury has sufficient fixation strength, and can achieve better effectiveness and joint function compared with traditional screw fixation.