Ozan TURHAL, Zekeriya Okan KARADUMAN, Yalçın TURHAN, Cemal GÜLER, Şengül CANGÜR, Mehmet ARICAN

Anatomik Ön Çapraz Bağ Rekonstrüksiyonun Femoral Tünel Oblisitesi İle İlişkisinin Klinik Olarak Değerlendirilmesi

Amaç: Artroskopik ön çapraz bağ (ÖÇB) rekonstrüksiyonlarında hamstring tendon grefti, patellar tendon grefti, allogreft gibi çeşitli tendon greftleri kullanılmaktadır. Çalışmamızda, Otojen Hamstring Tendonlar kullanılarak Anatomik Ön Çapraz Bağ Rekonstrüksiyonu uygulanan hastalarda femoral tünel oblisitesinin sonuçlarını güncel literatür eşliğinde değerlendirmeyi amaçladık.Gereç ve Yöntemler: Ocak 2013 – Haziran 2016 tarihleri arasında ön çapraz bağ rüptürü nedeniyle kliniğimizde cerrahi olarak tedavi edilen hastalar telefonla aranarak hastaneye davet edildi. Bunlar içerisinden fizik muayeneleri, grafi kontrolleri ve ölçümleri yapılan 64 hasta çalışmaya dâhil edildi.Bulgular: Hastalarımızın 55’i erkek, 9’u bayandı. Hastaların yaş ortalaması 29.3±8.12 (14-47) idi. Ortalama takip süremiz 14.47±7.44 (6-36) aydır. Kontrol Lysholm ve Tegner skoru ameliyat öncesi değerlerle karşılaştırıldığında istatistiksel açıdan ileri derecede anlamlı farklılıklar bulundu (p<0.001). International Knee Documentation Committee (IKDC) diz bağları değerlendirme sistemine göre ameliyat öncesi 3 hasta (%4.7) B, 18 hasta (%28.12) C ve 43 hasta (%67.18) D olarak saptandı. Ameliyat sonrası yapılan son kontrol muayenesinde 41 hasta (%64.06) A, 21 hasta (%32.81) B ve 2 hasta (%3.12) C grubuna dâhil edildi. Ortalama femur tüneli oblisitesi 41.2±7.2° bulundu. Sonuç: Ön çapraz bağ’ın rotasyonel stabilitesine oblik femoral tünel yerleşiminin daha fazla yarar sağladığı düşünülmektedir. Biz bu çalışmamızın sonucunda ön çapraz bağın otojen hamstring tendon grefti kullanarak anatomik teknikle uygulanmasının femoral tünel oblisite artışının fonksiyonel sonuca katkısının daha yararlı olduğu kanaatindeyiz.

Anahtar Kelimeler:

Anterior cruciate ligament reconstruction, rüptür, artroskopi

Clinical Evaluation of the Relationship of Anatomical Anterior Cruciate Ligament Reconstruction with Femoral Tunnel Obliquity

Aim: Various tendon grafts such as hamstring tendon graft, patellar tendon graft, allograft are used in arthroscopic anterior cruciate ligament (ACL) reconstructions. In our study, we aimed to evaluate in the light of the updated literature, femoral tunnel obliquity results of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring tendon graft. Material and Methods: Between January 2013 and June 2016, the surgically treated patients in our clinic who had anterior cruciate ligament (ACL) rupture were called and invited to hospital by telephone. 64 patients whose physical examinations, radiographs and measurements were completed have been included in the study.Results: 55 of our patients were male and 9 were female. The mean age of the patients was 29.3±8.12 (14-47) years. Total follow-up time was 14.47±7.44 (6-36) months. There were statistically significant difference between control and follow-up Lysholm and Tegner activity scores (p<0.001). According to the International Knee Documentation Committee (IKDC) knee ligation evaluation system, 3 patients (4.7%) were B, 18 patients (28.12%) were C and 43 patients (67.18%) were revealed as D in preoperative term. In the last postoperative examination, 41 patients (64.06%) were included in the group A, 21 patients (32.81%) B and 2 patients (3.12%) were included in the group C. The mean femoral tunnel obliquity was found as 41.2±7.2°. Conclusion: The oblique femoral tunnel placement is thought to be of greater benefit to the rotational stability of the ACL. As a result of this study, we are of the opinion that the application of anterior cruciate ligament with an anatomical technique using an autogenous hamstring tendon graft is more beneficial to the functional outcome of femoral tunnel obliquity increase.

Keywords:

Anterior cruciate ligament reconstruction, rupture, arthroscopy,

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