Arthroscopic GraftLink technique reconstruction combined with suture anchor fixation for anterior cruciate ligament and medial collateral ligament injuries_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Cheng ,  XIE Guoqing , JIN Wenxiao , REN Zhongming , XUE Jun , YANG Kun

Department of Joint Surgery, Zhejiang General Team Hospital of Chinese People’s Armed Police Force, Jiaxing Zhejiang, 314000, P.R.China;

Corresponding author：

XIE Guoqing, Email: xieguoqing2007@163.com

Keywords：

Arthroscopy; GraftLink technique; anterior cruciate ligament; medial collateral ligament; autologous tendon; suture anchor

DOI：

10.7507/1002-1892.201812062

Video：

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Objective To investigate the effectiveness of arthroscopic GraftLink technique reconstruction combined with suture anchor fixation in treatment of anterior cruciate ligament (ACL) rupture and medial collateral ligament (MCL) grade Ⅲ injury.Methods Between June 2015 and February 2018, 28 patients with ACL rupture and MCL grade Ⅲ injury were treated. Arthroscopic GraftLink technique was used to reconstruct ACL with autologous peroneus longus tendon (PLT), and suture anchor fixation was used to repair MCL. There were 22 males and 6 females, aged 21-47 years, with an average age of 30.4 years. The cause of injury included traffic accident in 18 cases, falling from height in 7 cases, and sports injury in 3 cases. The time from injury to admission was 1-2 weeks, with an average of 1.3 weeks. The preoperative Lysholm score of knee joint was 46.8±3.0 and the International Knee Documentation Commission (IKDC) score was 49.2±2.7. The American Orthopaedic Foot and Ankle Society (AOFAS) score of ankle joint was 98.29±0.72. Both Lachman test and valgus stress test were positive. There were 8 cases of meniscus injury and 2 cases of cartilage injury.Results The operation time ranged from 55 to 90 minutes, with an average of 72.5 minutes. All incisions healed by first intention after operation, and no complications related to operation occurred. All patients were followed up 6-38 months, with an average of 20.7 months. At 3 months after operation, the range of motion of the knee joint was 116- 132°, with an average of 122°. Lachman test showed that the anterior translation more than 5 mm in 2 cases, and the others were negative; while the valgus stress test showed that all patients were positive. At 6 months after operation, the Lysholm score and IKDC score of knee joint were 90.2±1.8 and 93.5±2.3, respectively, which were significantly higher than preoperative scores (t=31.60, P=0.00; t=29.91, P=0.01); AOFAS score of ankle joint was 97.86±0.68, with no significant difference compared with preoperative score (t=2.89, P=0.08). KT-1000 test showed that the difference of anterior relaxation between bilateral knee joints was less than 2 mm in 25 cases and 3 to 5 mm in 3 cases.Conclusion The method of ACL reconstruction via arthroscopic GraftLink technique with PLT and MCL repair via suture anchor fixation has the advantages of less knee injury and faster recovery, and there is no significant impact on ankle function after tendon removal.

Citation： WU Cheng, XIE Guoqing, JIN Wenxiao, REN Zhongming, XUE Jun, YANG Kun. Arthroscopic GraftLink technique reconstruction combined with suture anchor fixation for anterior cruciate ligament and medial collateral ligament injuries. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(6): 685-688. doi: 10.7507/1002-1892.201812062 Copy

1.	姚建华, 李海鹏, 黄炎, 等. 急性前交叉韧带损伤合并内侧副韧带损伤的治疗选择. 军医进修学院学报, 2011, 32(8): 801-802.
2.	曹红彬, 梁军, 辛景义, 等. 腓骨长肌重建治疗前交叉韧带损伤. 中华医学杂志, 2012, 92(35): 2460-2462.
3.	Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med, 1982, 10(3): 150-154.
4.	Reinhardt KR, Hetsroni I, Marx RG. Graft selection for anterior cruciate ligament reconstruction: a level Ⅰ systematic review comparing failure rates and functional outcomes. Orthop Clin N Am, 2010, 41(2): 249-262.
5.	Mc Dermott ID. Graft options for ACL reconstructive surgery. Orthopaedics and Trauma, 2013, 27(3): 156-163.
6.	陈百成, 张庆民, 冯建刚, 等. 自体中 1/3 髌韧带重建前十字韧带术后膝关节内并发症的探讨. 中华骨科杂志, 2000, 20(4): 216-218.
7.	连海云, 罗建成, 王波, 等. 关节镜下腘绳肌腱重建膝关节前交叉韧带损伤的临床研究. 实用骨科杂志, 2012, 18(6): 558-560.
8.	左立新, 高雁卿, 杨卫兵, 等. 腓骨长肌腱移植后对足弓的影响. 中国矫形外科杂志, 2009, 17(15): 1198-1199.
9.	史福东, 冯世庆, 左金增, 等. 关节镜下自体腓骨长肌腱和腘绳肌腱重建前交叉韧带的对比. 中华实验外科杂志, 2014, 31(11): 2531-2533.
10.	左立新, 高雁卿, 杨卫兵, 等. 关节镜下腓骨长肌腱移植重建交叉韧带七例. 中国修复重建外科杂志, 2007, 21(11): 1275-1276.
11.	Zhao J, Huangfu X. The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft sourse. Am J Sport Med, 2012, 40(3): 662-671.
12.	吴市春, 郑亚才, 严康宁, 等. 腓骨长肌腱与腘绳肌腱重建前交叉韧带的疗效比较. 中国修复重建外科杂志, 2015, 29(11): 1358-1363.
13.	Ziai P, Benca E, von Skrbensky G, et al. The role of the peroneal tendons in passive stabilization of the ankle joint: an in vitro study. Knee Surg Sports Traunmatol Arthrosc, 2013, 21(6): 1404-1408.
14.	Karimi M, Fatoye F, Mirbod SM, et al. Gait analysis of anterior cruciate ligament reconstructed subjects with a combined tendon obtained from hamstring and peroneus longus. Knee, 2013, 20(6): 526-531.
15.	Gefen A. Plantar soft tissue loading under the medial metatarsals in the standing diabetic foot. Med Eng Phys, 2003, 25(6): 491-499.
16.	Phisitkul P, James SL, Wolf BR, et al. MCL injuries of the knee: current concepts review. Iowa Orthop J, 2006, 26: 77-90.
17.	Zaffagnini S, Bignozzi S, Martelli S, et al. Does ACL reconstruction restore knee stability in combined lesions?: An in vivo study. Clin Orthop Relat Res, 2007, 454: 95-99.
18.	Bin SI, Nam TS. Surgical outcome of 2-stage management of multiple knee ligament injuries after knee dislocation. Arthroscopy, 2007, 23(10): 1066-1072.
19.	冯会威, 黄迅悟, 孙继桐, 等. 关节镜下应用带跟骨异体跟腱联合重建前交叉韧带及内侧副韧带. 现代生物医学进展, 2013, 13(13): 2472-2475.
20.	钱雪梅, 董伟强, 刘素霞, 等. 关节镜下膝关节多发韧带损伤重建术后的康复护理. 中华关节外科杂志(电子版), 2013, 7(1): 52-55.
21.	祝涛. 关节镜下前交叉韧带重建术病人术后功能锻炼的效果观察. 全科护理, 2011, 9(13): 1153-1154.
22.	刘德全, 冯华, 洪雷, 等. 急性膝关节多发韧带损伤的早期治疗. 中华骨科杂志, 2003, 23(12): 719-722.

1. 姚建华, 李海鹏, 黄炎, 等. 急性前交叉韧带损伤合并内侧副韧带损伤的治疗选择. 军医进修学院学报, 2011, 32(8): 801-802.
2. 曹红彬, 梁军, 辛景义, 等. 腓骨长肌重建治疗前交叉韧带损伤. 中华医学杂志, 2012, 92(35): 2460-2462.
3. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med, 1982, 10(3): 150-154.
4. Reinhardt KR, Hetsroni I, Marx RG. Graft selection for anterior cruciate ligament reconstruction: a level Ⅰ systematic review comparing failure rates and functional outcomes. Orthop Clin N Am, 2010, 41(2): 249-262.
5. Mc Dermott ID. Graft options for ACL reconstructive surgery. Orthopaedics and Trauma, 2013, 27(3): 156-163.
6. 陈百成, 张庆民, 冯建刚, 等. 自体中 1/3 髌韧带重建前十字韧带术后膝关节内并发症的探讨. 中华骨科杂志, 2000, 20(4): 216-218.
7. 连海云, 罗建成, 王波, 等. 关节镜下腘绳肌腱重建膝关节前交叉韧带损伤的临床研究. 实用骨科杂志, 2012, 18(6): 558-560.
8. 左立新, 高雁卿, 杨卫兵, 等. 腓骨长肌腱移植后对足弓的影响. 中国矫形外科杂志, 2009, 17(15): 1198-1199.
9. 史福东, 冯世庆, 左金增, 等. 关节镜下自体腓骨长肌腱和腘绳肌腱重建前交叉韧带的对比. 中华实验外科杂志, 2014, 31(11): 2531-2533.
10. 左立新, 高雁卿, 杨卫兵, 等. 关节镜下腓骨长肌腱移植重建交叉韧带七例. 中国修复重建外科杂志, 2007, 21(11): 1275-1276.
11. Zhao J, Huangfu X. The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft sourse. Am J Sport Med, 2012, 40(3): 662-671.
12. 吴市春, 郑亚才, 严康宁, 等. 腓骨长肌腱与腘绳肌腱重建前交叉韧带的疗效比较. 中国修复重建外科杂志, 2015, 29(11): 1358-1363.
13. Ziai P, Benca E, von Skrbensky G, et al. The role of the peroneal tendons in passive stabilization of the ankle joint: an in vitro study. Knee Surg Sports Traunmatol Arthrosc, 2013, 21(6): 1404-1408.
14. Karimi M, Fatoye F, Mirbod SM, et al. Gait analysis of anterior cruciate ligament reconstructed subjects with a combined tendon obtained from hamstring and peroneus longus. Knee, 2013, 20(6): 526-531.
15. Gefen A. Plantar soft tissue loading under the medial metatarsals in the standing diabetic foot. Med Eng Phys, 2003, 25(6): 491-499.
16. Phisitkul P, James SL, Wolf BR, et al. MCL injuries of the knee: current concepts review. Iowa Orthop J, 2006, 26: 77-90.
17. Zaffagnini S, Bignozzi S, Martelli S, et al. Does ACL reconstruction restore knee stability in combined lesions?: An in vivo study. Clin Orthop Relat Res, 2007, 454: 95-99.
18. Bin SI, Nam TS. Surgical outcome of 2-stage management of multiple knee ligament injuries after knee dislocation. Arthroscopy, 2007, 23(10): 1066-1072.
19. 冯会威, 黄迅悟, 孙继桐, 等. 关节镜下应用带跟骨异体跟腱联合重建前交叉韧带及内侧副韧带. 现代生物医学进展, 2013, 13(13): 2472-2475.
20. 钱雪梅, 董伟强, 刘素霞, 等. 关节镜下膝关节多发韧带损伤重建术后的康复护理. 中华关节外科杂志(电子版), 2013, 7(1): 52-55.
21. 祝涛. 关节镜下前交叉韧带重建术病人术后功能锻炼的效果观察. 全科护理, 2011, 9(13): 1153-1154.
22. 刘德全, 冯华, 洪雷, 等. 急性膝关节多发韧带损伤的早期治疗. 中华骨科杂志, 2003, 23(12): 719-722.

Chinese Journal of Reparative and Reconstructive Surgery

Arthroscopic GraftLink technique reconstruction combined with suture anchor fixation for anterior cruciate ligament and medial collateral ligament injuries

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