Investigation Of The Arthroscopic Autogenous Midthird Patellar Tendon (B-PT-B) For Reconstruction Of The Anterior Cruciate Ligament

Anterior cruciate ligament (ACL)is the significant composition that is steady in the preceding direction of knee joint .The injuries afterwards may lead to be obviously unfirm in the preceding direction of knee joint ; badly affect the function of knee joint ; secondary damage the main composition such as articular cartilage and meniscus ;cause articular degeneration and articular disease happen in early phase .There are three chief faults in the traditional incising reconstruction operation ,the one is that articular capsule is incised widely,the second is that overtopping point′s exposure is difficult and the graft is difficult to equal in length to transplant, the third is that the patients need outside fixation whose gaft fixed by button,articular adherence and unstability always occur in some patient,and the majority is difficult to recovery agonistic athletics .In the wake of quick development of the arthroscopic reconstruction technique of anterior cruciate ligament,depending on looking steadily at observation and operation,by right of the following merits which include small incisions,less trauma,accurate operation,fewcomplication,quick recovery and so on,the arthroscopy technique makes a great evolution in treating trauma.Arthroscopic reconstruction of anterior cruciate ligament(ACL) becomes the rule in the department of orthopaedics. The material for arthroscopic reconstruction of anterior cruciate ligament is midthird patellar tendon autograft (B-PT-B),semitendinosus-gracilis autograft or quadriceps femoris tendon autograft. The operation adopting midthird patellar tendon (B-PT-B) has become the golden standard of the arthroscopic recontruction,because the midthird patellar tendon autograft has the following characteristics of well tensile strength,tensile strength being close to the most largestest strenth of normal ACL and firm fixation. Although the arthroscopic reconstruction improves on day by day , yet the therapeutic efficacy is not fine to some patients.The main manifestations display ache of joint,lost of movement of a certain degrees of joint and articular unstability. The main elements that cause ACL's reconstruction pitfall consist of :(1)preoperative element: stability of the joint and association injury of meniscus and cartilage or not.(2)intraoperative element:graft materials,to take shape of the intercondylar fossa ,location of bone tunnel,tension of graft, fixation and orther problems.(3)postoperative element:healing of the graft outside bone tunnel,rehabilitation training and to be injured again. The text emphasized elaborately the intraoperative element. Conclusion: (1)The accurate location and correct direction of the bone tunnels are fundamental for the prevention of the struck of the intercondylar fossa and the pitfall of ACL reconstruction .(2)The following issues should be considered for the selection of the graft:The strengh of the material,the healing of the graft,damage to the donor site and the establishment of insertion site on the normal ligament after transplantation.(3)Firm fixation is essential for the prevention of slippage of graft from bone tunnel and for early stage function training.