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Beitragstitel No improved “ligamentization” with preservation of the distal Hamstrings insertions in anterior cruciate ligament reconstruction assessed on 3- and 6-months postoperatively MRI - a prospective randomized controlled study.
Beitragscode P33
Autoren
  1. Filippo-Franco Schiapparelli EOC - Ospedale Regionale di Lugano Vortragender
  2. Pietro Feltri EOC (Ente Ospadaliero Cantonale) - Ospedale Regionale di Lugano
  3. Vito Chianca EOC (Ente Ospadaliero Cantonale) - Ospedale Regionale di Lugano
  4. Filippo Del Grande EOC (Ente Ospadaliero Cantonale) - Ospedale Regionale di Lugano
  5. Luca Deabate EOC (Ente Ospadaliero Cantonale) - Ospedale Regionale di Lugano
  6. Giuseppe Filardo EOC (Ente Ospedaliero Cantonale) - Ospedale Regionale di Lugano
  7. Christian Candrian Ente Ospdealiero Cantonale EOC
  8. Marco Delcogliano Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
Präsentationsform Poster
Themengebiete
  • A05 - Knie
Abstract Objectives
To evaluate if in anterior cruciate ligament (ACL) reconstruction, the preservation of the distal insertion of the hamstrings leads to an improved “ligamentization” process evaluated on sequential postoperative 3 tesla MRI.

Methods
25 active patients with traumatic ACL tears without relevant accessory knee lesions were prospectively enrolled and randomized into 11 patients (Group HP; mean age ± SD: 31.8 years ± 11.4; M : F 5 : 6) who underwent ACL reconstruction with preservation of the distal insertions of the hamstrings and 14 patients (Group HD; mean age ± SD: 27.6 ± 10.6; M : F : 12 : 2) who underwent ACL reconstruction with a classic detachment of distal insertion of the hamstrings. Groups were comparable for age and gender.
In all patients a classical double-tunnel anatomical technique was used. The graft was proximally fixed with an EndoButton in both groups.
Distally, in order to preserve the Hamstrings vascularization in group HP, after the graft tensioning, only the free end of the graft was fixed with a stable just outside the tibial tunnel without damaging the preserved distal Hamstring insertion. In group HD the distal ends of the graft were fixed in a classic technique with an interference screw.
The “ligamentization” process was evaluated on 3- and 6-months postoperative MRIs as follows: ALC signal intensity measured with the Signal/Noise Quotient (SNQ) at the intratibial, intra-articular and intra-femoral portions; graft integration evaluated as presence of hyperintense signal at the bone-graft interface. The graft inclination was assessed in grades on the sagittal plane. Radiological assessments were performed from two observers and the mean value of each measure was used for statistics. All measures were compared between groups with the Mann-Whitney Test.

Results
The SNQ at 3- and 6-months postoperatively did not differ at the intratibial, intra-articular and intra-femoral ACL portions between groups. Graft integration evaluated as presence of hyperintense signal at the bone-graft interface was present in all patients at 3 and 6 months postoperatively.
The mean ACL inclination did not differ significantly between groups and was 45.7° ± 4.9° in group HD and 48.2° ± 4.7° in group HP.

Conclusions
The preservation of the distal insertion of the hamstrings seems to not influence the “ligamentization” process assessed on 3 and 6-months postoperative MRIs.