Arthroscopic treatment in lesions of anterior cruciate ligament of the knee

Abstract

Introduction. From the total knee injuries, those of anterior cruciate ligament are the most frequent, the incidence of ACL injuries has increased from 86687 in 1998 to 129836 in 2012. The anatomical-functional and biomechanical particularities, predispose the knee joint to frequent trauma, especially in young people with increased functional activity. ACL plays an important role in the biomechanics of the knee, it’s taking over 85% of the force that translates anteriorly the tibia, preventing its sliding anterior in relation to the femur, otherwise limiting the hyperextension. Arthroscopic reconstruction of the ACL remains the most used technique in the world, offering the possibility of reconstructing the ACL according to the anatomy of knee, in the hope of obtaining an articular function as possible close to the physiological one. Aim of the study. To evaluate the efficacy and advantages of arthroscopic surgery in the reconstruction of the anterior cruciate ligament of the knee. Materials and methods. The study included a group of 68 patients after an arthroscopic treatment in the Traumatology I section of the SCTO IMSP in Chisinau.There were evaluated clinical data (patients complains on hospitalization): pain in the knee joint, joint instability, joint blockage. Laboratory analysis, electrocardiogram, MRI of the knee joint were performed in all patients. Antero-medial instability of the knee was determined using the Lachman test and the anterior drawer. Surgical treatment include anterior cruciate ligament transplantation and resection of the injured portion of the meniscus. Results. The average age of the patients was 31 years. From 68 patients 79.40% suffered sport trauma, 20.59% suffered habitual trauma, and in the other 2.96% the LIA injury occurred as a result of road accidents. The meniscus lesion was detected in 45.6%, of which, in 23.5% the lesion of anterior cruciate ligament resulted in lesion of the medial meniscus, in 17.7% occurred the lesion of lateral meniscus, and 4.4% of the patients were injured both medial and lateral meniscus. Methods used in restoration of ACL were predominantly hamstring autografts, fixed with femoral endobutone and tibial interference screw. Conclusions. The implementation of the endoscopic technique has produced enormous progress in knee joint surgery, being the most accessible and the most accurate method of diagnosis and treatment in ACL injuries. Selection of the surgical treatment method in combination with a complex of post-operative exercises, contributes to the restoration of the joint function at the patients with ligamentous knee injuries.