The Comparative Study Of The Implant Angle And Length In Anterior Cruciate Ligament Reconstruction Between Two Kinds Of Approach Technology

Objectives To compare the implant angle and length in anterior cruciate ligament reconstruction between two kinds of approach technology.Exploring and discussing the connection between the shape of implant and clinical efficacy,in order to provide theory evidence for choosing the better way of reconstructing ACL.Methods Analyzed of 80 clinical cases: 35 cases from TT(Male:16,Female:19,age from 21-61,average age is 29.33 ± 5.37),45 cases from AM(Male:23,Female:22,age from 19-56,average age is 31.49 ± 6.11).The surgery of two groups patients were operated by the same surgeon.After the surgery,the same rehabilitation exercises are adopted.All the patients will be examined using CT reconstructing in 2 weeks.Measuring the length of implant and updip angle(the angle between graft axis and tibia platform level)by CT image processing system.In the surgery,measuring the biggest degree of variability of implant length that outside the tibial bone when the knee crooking0°-120° by sterile vernier calipers before screwing the absorbable screw into the tibial.Evaluating the implant isometric characteristic during the knee flexion and extension.After surgery when follow up,doing Lachman test and pivot-shift test to patients,knee to evaluate the before and rotational stability of the knees.Examining the activity of knee,and using Lysholm score and IKDC score to evaluate the level of activity function of knee.Conducting statistical analysis to the above data and result in the end.Results Measuring result of the updip angle and length of the implant: TT group is(57.13±5.51)°,(31.88±2.57)?;AM group is(54.08±6.32)°,(31.00±3.25)?,the updip angle of the implant in TT group is bigger than AM group,two group difference was significant(P<0.05),two groups showing no significant difference in the length of the implants(P>0.05).The biggest degree of variability of implant length that outside the tibial bone when knee flexion and extension,TT group is(2.44±0.82)?;AM group is(2.22 ± 0.84)?,two groups were not statistically significant(P > 0.05).At the postoperative follow-up,Lachman test result:2 cases are positive in TT group;3 cases are positive in AM group,two groups were not statistically significant(P>0.05);Pivot shift test result: 5 cases are positive in TT group;1 cases are positive in AM group,the difference was statistically significant(P<0.05).The active flexion angle of the knees:TT group are(116.40±10.20)°,AM group are(117.56±8.82)°,the difference was statistically significant(P>0.05).Lysholm score and IKDC score after the operation,TT group are(89.83±4.76),(86.31±4.11);AM group are(89.58±5.22),(87.67±3.85),two groups were not statistically significant(P>0.05).The length and updip angle of the implants have relativity(R = ? 0.228,P = 0.042),the isometric characteristic of the implant and the postoperative Lysholm score have relativity(R=?0.571,P=0.000).Conclusions 1 The difference of reconstructing implant length and isometric characteristic from TT and AM is not obvious.The updip angle of TT group is bigger than AM group.implant updip angle showing the negative connection with length.2 The difference of before stability,activity and function scores from TT and AM is not obvious.The rotational stability from TT is better than from AM.3 The isometric characteristic of implant better,the better of postoperative effect.