Comparative Clinical Efficacy Analysis Of The Anterior Cruciate Ligament Of Anatomical Single-bundle Reconstruction With Isometric Single-bundle Reconstruction

Anterior cruciate ligament (anterior cruciate ligament, ACL) injury is the most common sports injuries of the knee is one. According to statistics, accounting for about 80% of knee ligament injury. ACL injury can lead to knee instability, affecting the joints before the recent vertical and rotation stability and secondary cause a corresponding meniscus and cartilage damage, forwards can accelerate the degeneration of the knee joint, causing irreversible degenerative knee sex change. Therefore, ACL injuries have to study more and more attention. Currently arthroscopic ACL reconstruction surgery has been the gold standard for treatment of ACL injury. Biomechanical stresses, ACL bundle branch alternately each state of tension, on the whole maintained a constant tension, that regardless of the knee flexion angle, and always maintain the stability of the knee joint and the surface load. It makes a traditional anterior cruciate ligament reconstruction core philosophy-as long reconstruction, that no matter what kind of knee flexion angle in, and always maintain the femur for reconstruction of the ACL tibial point equidistant, thus ensuring a constant tension of the knee. This method can greatly recover the stability of the knee joint, especially the former portrait stability limit of anterior, a good recovery of the exercise capacity. But also the pursuit of equal length, the reconstructed ACL will greatly deviated from the original anatomical position. But in recent years, more and more studies show that knee flexion angles in each ACL tension are not identical, does not advocate for the reconstruction of the excessive pursuit of equal length. Studies show, ACL reconstruction patients after such a long, only 61%-67% IKDC score qualified. Isometric ACL reconstruction does not prevent early postoperative osteoarthritis appears. Thus in recent years, ACL anatomical reconstruction (the anatomical reconstruction of anterior cruciate ligament) concept is proposed, either bone, muscle, tendon, ligament damage, only the maximum recovery of the anatomy, in order to maximize the recovery of its functions. Most laboratory studies have shown superior anatomical reconstruction reconstruction of equal length, and the current on the clinical efficacy of the two remains controversial, this study by comparing the two in improving the clinical efficacy of knee function, analyze whether they have a more anatomic reconstruction big advantages.[Objective] To compare the clinical curative effect of anatomical and isometric reconstruction method for anterior cruciate ligament reconstruction.[Method] Retrospective analysis confirmed arthroscopic anterior cruciate ligament rupture in 80 patients, divided by reconstruction Group A:isometric reconstruction; B Group:anatomical reconstruction of the 40 patients underwent four shares autogenous hamstring tendon single-bundle reconstruction, both femoral fixation RIGIDFIX, tibia INTRAFIX. X-rays taken after surgery and three-dimensional CT, knee function using joint ROM, Lachman and pivot shift test, IKDC, Lycholm, KT-2000 score judgments.[Result] Follow-up time was 12 months,80 patients had no follow-up period longer ligament rupture, apparent joint swelling and activity limitation. X-rays:A, B group tibial bone tunnel centers are located tibial around at 37.7%,34.2%, femoral bone tunnel center average in Blumensaat’s line after 21.4%,19.8% two knee Lysholm score, KT-2000 score, IKDC scores were significantly higher than the reconstruction of the anterior (P<0.05); reconstruction and follow-up of the two groups before the Lysholm knee score, KT-2000 score, IKDC score difference was not significant (P> 0.05). Isometric reconstruction group,10 cases of grade Ⅰ Lachman sign, two cases of Ⅱ degree.16 cases of I degree pivot shift test, five cases of Ⅱ degree.8 patients with anatomical reconstruction levy Lachman grade Ⅰ,Ⅱ degree two cases.4 cases of grade I pivot shift test, no II degree. Only two groups pivot shift test positive difference between the rate was significant (P<0.05). Show arthroscopic anatomic and isometric bundle anterior cruciate ligament reconstruction alone can achieve satisfactory clinical efficacy, both in improving function in patients with knee stability and activity did not differ, but the anatomical reconstruction of rotational stability of the knee in patients after better.[Conclusion] Anatomic ACL reconstruction and long reconstruction both in clinical practice with good results, but in terms of rotational stability after the former better.