Der Unfallchirurg
-
Randomized Controlled Trial
[Anatomic anterior cruciate ligament reconstruction with hamstrings using press-fit fixation without hardware: operative technique and long-term results of a prospective and randomized study].
An innovative technique for anterior cruciate ligament (ACL) reconstruction has been developed in 1998 which allows the grafts to be fixed by press-fit to the femoral and tibial tunnel without any hardware. The semitendinosus (ST) and gracilis tendons (GT) are built into a sling by tying a knot with the tendon ends and securing the knot after conditioning by sutures. For the femoral tunnel the anteromedial porta is used. ⋯ Re-rupture rates, subjective findings, knee stability and isokinetic testing showed similar results for both grafts. This is the first level I study which demonstrates cartilage protection by ACL reconstruction as long as the meniscus is intact at index surgery, shown by bilateral MRI analysis 9 years post-operation. There was no significant difference in the average grade of chondral and meniscus lesions between BPT and HT and in comparison of the operated to the intact knee, except for grade 3-4 lesions found at the 9 year follow-up, which were significantly higher in the BPT group.