The Clinical Study Of Anterior Cruciate Ligament Reconstruction With Femoral Tunnel Through Accesory Medial Approach

Purpose: To investigate the characteristics and clinical effect of ACL reconstruction through MP approach and AMP approach.Methods: From September 2016 to December 2018,76 ACL reconstruction patients(76 knees)were included from the Department of joint and sports medicine of Ruikang Affiliated Hospital of Guangxi University of Chinese medicine.According to the surgical approach,they were divided into MP group(40 knees)and AMP group(36 knees).Threedimensional CT reconstruction was used in both groups after operation.Mimics 17.0 software was used to reconstruct the joint image,excise the internal condyle of femur,compare the position of femur tunnel,the length of femur tunnel,the area of femur tunnel,the angle between femoral tunnel and tibia plateau(α),the volume of femoral tunnel,the bending angle of ligament,KT-2000,and compare the Lysholm score,IKDC score,and VAS score of the two groups preoperative and postoperative 6 weeks,3 months,6 months and 12 months.After operation,the patients in the two groups were treated with acupuncture and Bolus of Six Drugs Including Rehmanniato.Results: All patients were followed up for more than 12 months,with an average follow-up time of(14.2 ± 2.1)months.It was found that the VAS pain score of the two groups before and 6 weeks,3 months,6 months and 12 months after operation was not statistically significant(P > 0.05);in the comparison of Lysholm score,the amp group was higher than MP group in the three months after operation,with a statistically significant difference(P < 0.001)There was no significant difference between the two groups(P > 0.05);according to mochizukis positioning method,the position of femoral tunnel in MP group was more forward than that in amp group,the difference was statistically significant(P < 0.001);in the length of femoral tunnel,the position of femoral tunnel,the length of femoral tunnel,the area of femoral tunnel,the angle between femoral tunnel and tibial platform(α),the body of femoral tunnel In the comparison of volume and bending angle,amp group was smaller than MP group,the difference was statistically significant(P < 0.001);in the comparison of knee joint activity 12 months after operation,there was no statistically significant difference between the two groups(P < 0.001).Conclusion: Amp group was inferior to MP group in bending angle,but there was no significant difference between MP group and amp group in joint range of motion and IKDC score.Amp group is superior to MP group in the position,length,area of the femoral tunnel,angle between the tunnel and tibial plateau(α),tunnel volume and Lysholm score of three months after operation.It has certain advantages in tendon and bone healing,which is worth popularizing clinically.At the same time,it is suggested to combine acupuncture and six digitalis pills to achieve satisfactory rehabilitation effect.