Using a New Method for Preparing an Autograft for Anterior Cruciate Ligament Plasty

Background. Currently, work continues to improve the methods of arthroscopic reconstruction of the anterior cruciate ligament with an autograft, aimed at reducing the risk of postoperative failure.

Aim of the study. To assess the immediate results of using a new method of preparing an autograft for anterior cruciate ligament plasty.

Materials and methods. The analysis of the results of surgical treatment of 28 patients with old complete traumatic rupture of the anterior cruciate ligament, who were treated in the Department of traumatology and orthopedics of the Irkutsk Scientific Center of Surgery and Traumatology, was carried out. The patients were men aged 18 to 40 years. The common thing for all patients was the All-inside arthroscopic plasty of the anterior cruciate ligament. Two groups of patients were formed depending on the method of preparation of the autograft. The first group consisted of 18 patients in whom a well-known technique was used, including the formation of a four-bundle autograft from one tendon of the semitendinosus muscle. In 10 patients of the second group, a new method of preparing an autograft was used, including the stage of preliminary determination of the required length and thickness of the autograft, and the stage of forming an autograft from the tendon of the semitendinosus and gracilis muscles on the common tendon pedicle.

Results. Comparative analysis of the immediate results of arthroscopic plasty of the anterior cruciate ligament with an autograft in case of its old complete traumatic injury revealed a significantly lower number of undesirable consequences when using a new method of preparing an autograft. In two cases, persistence of  the pain syndrome associated with arthritic changes in the joint was observed, in one patient there was a  restriction of movements in the knee joint, no synovitis, a sensation of instability of the knee joint, ruptures  and detachments of the autograft were found. All patients were satisfied with the achieved result.

Conclusion. A new method of preparing an autograft for plasty of the anterior cruciate ligament allows  achieving anatomical reconstruction of the anterior cruciate ligament, optimal function of the knee joint,  reducing pain, significantly reducing the risk of developing knee instability, ruptures and abruptions of the autograft in the postoperative period due to an individual approach, increasing the strength of the autograft and the strength of its fixation in the bone canals.

1. Slastilin VV, Fine AM, Vaza AYu. Using hamstring tendon graft for anterior cruciate ligament reconstruction (advantages, problems and solutions). The Russian Journal of Transplantation. 2017; 9(4): 317-324. (In Russ.)

2. Rikun OV, Khominets VV, Fedotov AO. Current trends in the surgical treatment of patients with ruptures of the anterior cruciate ligament (literature review). Traumatology and Orthopedics of Russia. 2017; 23(4): 134-145. (In Russ.)

3. Slastilin VV, Yarygin NV, Parshikov MV, Sychevsky MV, Fine AM. Modification of the method of preparation and installation of a four-fascicle autograft from the semitendinosus tendon for anterior cruciate ligament plasty. Genij ortopedii. 2019; 25(3): 277-284. doi: 10.18019/1028-4427-2019-25-3-277-284. (In Russ.)

4. Leonova SN, Monastyrev VV, Ponomarenko NS. Using a new approach to arthroscopic autoplasty of the anterior cruciate ligament in case of its traumatic injury. Polytrauma. 2019; (4): 52-57. (In Russ.)

5. Grafton RD, Lyon DL, Hallet B. High strength suture material: Patent US6716234B2.

6. Grafton RD, Schmielding R. High strength suture with coating and colored trace: Patent US7029490.

7. Morrison DS, Hacker RL. Stiff tipped suture: Patent US7147651.