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Department of Orthopedics and Traumatology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020 |
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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. |
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