Maurilio Marcacci
Rizzoli Orthopedic Institute, Italy
Posters & Accepted Abstracts: J Sports Med Doping Stud
The persistence of rotatory laxity has been reported even after cases of uneventful ACL reconstruction, suggesting that a singlebundle intra-articular reconstruction could not be sufficient to completely restore rotational knee stability in certain patients. In 1993, we developed a unique surgical procedure that utilizes the hamstring tendons with intact tibial insertion distally for an intra-articular single bundle over-the top ACL reconstruction and extra-articular augmentation performed with the remnant part of the hamstring graft. At 11 years follow-up, the IKDC score demonstrated good or excellent results in 90.7% of patients. Ligament arthrometry using the KT-2000 arthrometer demonstrated that only 2 patients had >5 mm manual maximum side-to-side difference in laxity. The mean Tegner activity score was 4.5, while the mean Lysholm score was 97.3 and the mean subjective score was 90.0%. We evaluated the results of the latter technique with computer-assisted navigation and found that the addition of an extra-articular procedure to the single-bundle ACL reconstruction successfully controlled coupled tibial translation during the Lachman test and reduced anteroposterior laxity at 90�° of flexion. The technique presented is a highly reproducible procedure in our hands, with a high percentage of satisfactory results, and eliminates the risk of surgical error that may be associated with placement of the femoral tunnel, it uses only 3 titanium staples for graft fixation, which results in a reduction of surgical costs, and it is capable of maintaining good stability, and without an increased rate of degenerative arthritis at more than 10 yearsâ�� follow-up.
Email: m.marcacci@biomec.ior.it
Journal of Sports Medicine & Doping Studies received 1022 citations as per Google Scholar report
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