Clinical Study Of Reconstruction Of Anterior Cruciate Ligament In Different Ways By Different Materials Under Arthroscopy

【 Objective 】 To investigate the postoperative clinical effects of different materials in different methods of reconstruction of anterior cruciate ligament(ACL)under arthroscopy,so as to provide a variety of references and corresponding theoretical support for clinical acl reconstruction.【Methods】The surgical cases and follow-up data of ACL reconstruction were analyzed in our joint surgery center from October 2016 to December 2017.According to the inclusion and exclusion criteria screening,98 cases were included,and they were divided into four groups according to the graft materials and different reconstruction methods.Namely group A(autograft not remnant-preserving reconstruction group),group B(autograft remnant-preserving reconstruction group),group C(allograft not remnant-preserving reconstruction group),group D(allograft remnant-preserving reconstruction group).The preoperative Lachman test,the stability of the anterior drawer test,the Lysholm score,the Tegner activity score functional index and the VAS pain score were evaluated in four groups of patients,and the blood test was performed on the inflammation index.The differences of operation time in each group were observed during operation.The changes of drainage volume and inflammatory index in each group were observed early after operation,and the stability index,functional index and VAS pain score and proprioceptive recovery were recorded during follow-up.comprehensive evaluation of different materials used in arthroscopic reconstruction Comparison of clinical outcomes obtained by the different method.[Results] The follow-up time of the four groups of patients was 12 to 26 months,with an average of 18.3±3.6 months.1.Analysis of autologous tendon remnant-preserving and not remnant-preserving reconstruction: In the perioperative period,3 days after surgery,there were significant differences between the two groups in group A and B in the erythrocyte sedimentation rate and high-sensitivity C-reactive protein group(P<0.05).5 days after surgery,There was no significant difference between the two groups in white blood cell count,erythrocyte sedimentation rate and high-sensitivity C-reactive protein group(P>0.05).At 12 months follow-up,there was no significant difference between the A and B groups in the stability and VAS pain scores(P>0.05),between functional,proprioceptive recovery,surgical time,and postoperative drainage,the difference was statistically significant(P<0.05).2.Analysis of not remnant-preserving reconstruction of autologous tendon and allogeneic tendon: Perioperative period,5 days after surgery,there were significant differences in white blood cell count,erythrocyte sedimentation rate,and high-sensitivity C-reactive protein between the two groups(P<0.05).At 12 months follow-up,there was no significant difference in stability,functionality,VAS pain score,and proprioceptive recovery between the two groups(p>0.05).The operation time and postoperative drainage were performed in the two groups,the difference between the groups was statistically significant(p<0.05).3.Analysis of the remnant-preserving of autologous tendon and allogeneic tendon: in the perioperative period,5 days after surgery,there were significant differences between the B and D groups in white blood cell count,erythrocyte sedimentation rate and high-sensitivity C-reactive protein group(P<0.05).At 12 months follow-up,there was no significant difference in stability,functionality,VAS pain score,and proprioceptive recovery between the two groups(P>0.05).There were significant differences between the B and D groups in the operation time and postoperative drainage volume(P<0.05).【Conclusion】 Arthroscopic autologous and allogeneic tendon can achieve good results with not remnant-preserving and remnant-preserving reconstruction.Autologous tendon has less inflammatory reaction after allogeneic tendon surgery,and it is convenient to take,but the donor area is prone to complications.The proprioception recovery after the reconstruction of the remnant-preserving was significantly better than that of the not remnant-preserving reconstruction group.