current%20concept%20in%20arthroscopic%20ACL%20reconstruction - SlideFinder - PowerPoint search engine with thumbnail results
Ebrahimzadeh M.H. MD
Department of Orthopedic surgery, Ghaem Hospital
Mashhad University of Medical Sciences, Mashhad, Iran
Frequency It is currently one of the most common orthopedic procedures in the world
6th frequent orthopedic surgery in US
100000 ACL tears each year
75 000 annually primary ACL reconstruction, 3000-1000 revision
The most frequent Orthopedic procedure in US 1. Knee arthroscopy and meniscectomy
2. Shoulder arthroscopy and decompression
3. Carpal tunnel release
4. Knee arthroscopy and chondroplasty
5. Removal of support implant
6. Knee arthroscopy and anterior cruciate ligament reconstruction
Who is candidate for ACL reconstruction ? Knee instability& pain
Young ; athlete
No or a little DJD
Liden et al. Am J Spot Med, 2007; 35
a prospective, randomized study with a 7-Year follow-up. 34/ 37 pt
----No Significant differences in Lysholm score and IKDC score; patient`s function
BPTB versus Hamestring tendon
Pinczewski et al. AM Jsport Med. 2007; 37
90 BTBG with 90 ST.Gracilis 10 years Follow-up
No difference in function; Lysholm score, IKDC
More morbidity in donor site in BTBG
More Petellofemoral DJD in BTBG
Graft Choices Allograft
Bone-patellar tendon-bone
Achilles’ tendon
Hamstrings
Quadriceps tendon
Fascia lata
Autograft vs. Allograft Viral disease transmission (1:1million)
Deep freezing leaves some cells (10%)
Freeze-drying & cryo weaken graft; limited self-life
Graft incorporation & remodeling is faster with autografts. (graft is weakest @ 8-12wks)
Donor site morbidity with autografts
Graft Fixation
Interfnce screw
Biodegradable
Metalic
Bio vs Metal Screw
Laxdal G. et al. BioVs Metalic Screw
Am J Sports Medicine 2006
77pts in a prospective randomised study;
6-24 months,,,, the same function outcome
-larger drill hole in bio group
Intefrance Screw
Transfix
Transfix pin/screw
Rose et al. :J of Knee Surg, Sport Traumatolo. 2006
Prospective randomized study of Transfix vs Bio screw for hamstring reconstruction
-38 patients with Transfix versus 30 Bio screw with 12 months follow-up
No significant difference in outcome
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