Üzeyir TIRMIK, Mahir MAHİROĞULLARI, Mesih KUŞKUCU

Ön çapraz bağ yırtığının femoral askı çivisi (cross-pin) sistemi ile rekonstrüksiyonunun orta dönem sonuçları

Amaç: Bu çalışmada ön çapraz bağ (ÖÇB) yırtığının hamstring otogrefti ve femoral askı sistemi ile tedavisi ve sonuçları incelenmiştir. Çalışma planı: Olgularımızın 49'u erkek,1'i kadın (ortalama yaş: 27.4; dağılım: 15-44) idi. Yirmi yedi hastada sağ diz ve 23 hastada sol dizde lezyon mevcuttu. Profesyonel sporla uğraşan hastamız yoktu. Daha önce subkondral drilling veya mikro kırık uygulanan kondral lezyonlu hastalar ve diz bölgesinden cerrahi geçiren hastalar çalışmaya dahil edilmedi. Hastaların tümünde otojen dörtlü hamstring grefti ile ÖÇB rekonstrüksiyonu gerçekleştirildi. Otuz beş hastanın, cerrahi sırasında tespit edilen menisküs problemlerine parsiyel menisektomi uygulandı. Bütün hastalara postoperatif dönemde benzer hızlandırılmış iyileştirme programları uygulandı. Hastalar ameliyat öncesi ve sonrası Lysholm, International Knee Documentation Committee (IKDC) skorlama ve Tegner aktivite derecelendirme sistemleri ile takip edildiler. Bulgular: Toplam takip süresi ortalama 43.9 (dağılım: 29-57) aydı. Postoperatif son kontrollerde Lysholm skorlamasına göre 47 hasta iyi ve mükemmel gruplarında yer aldılar. IKDC skorlamasına göre 48 hasta A ve B gruplarında yer aldı. Tegner aktivite skoru ameliyat öncesi ortalama 5.9 (dağılım: 4-9) iken, ameliyat sonrası geç takiplerde ortalama 5.4 (dağılım: 2-9) olarak bulundu. Çıkarımlar: ÖÇB rekonstrüksiyonunda dörtlü hamstring tendonu ve askı çivisi sistemi ile yapılan cerrahi tedavinin güvenli ve orta dönem sonuçlarının başarılı olduğu görüşüne varılmıştır.

Anahtar Kelimeler:

Ön çarpraz bağ onarımı, İleriye dönük çalışma, Hareket açıklığı, eklem, Ön çapraz bağ, Tedavi sonucu, Tendonlar, Yaralanma şiddeti skoru, Diz yaralanmaları, Kemik çivileri

The results of reconstruction of the ACL using the cross-pin femoral system and four-strand hamstring tendon autografts

Objective: The aim of this study was to evaluate the results of ACL reconstruction using a cross pin femoral fixation system and hamstring autografts. Methods: The study included 49 men and one woman (mean age: 27.4 years; range: 15 to 44 years) with chronic ACL ruptures operatively treated between 2003 and 2006. Involvement was in the right knee in 27 patients, and the left knee in 23. There were no professional athletes included in the study. Patients with chondral lesions of the knee treated by microfracture or drilling or operated previously were excluded from the study. All patients had an ACL recon struction with an autogenous four-strand hamstring graft. Thirty-five patients received treatment for other meniscal pathologies. All patients followed a similar accelerated rehabilitation program after surgery. Final evaluations were made using the Lysholm and International Knee Documentation Committee (IKDC) scoring systems and the Tegner activity rating system in the final follow-up. Results: Mean follow-up time was 43.9 (range: 29-57) months. Lysholm scores were good or excellent for 47 patients. IKDC scores were either Grade A or B for 48 patients. The mean Tegner activity score was 5.9 (range: 4-9) in the preoperative and 5.4 (range: 2-9) in the late post operative period. Conclusion: Reconstruction of the ACL using four-strand hamstring tendons and cross-pin femoral fixation may be a safe and effective method, resulting in considerably high success rates.

Keywords:

Anterior Cruciate Ligament Reconstruction, Prospective Studies, Range of Motion, Articular, Anterior Cruciate Ligament, Treatment Outcome, Tendons, Injury Severity Score, Knee Injuries, Bone Nails,

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