Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (26): 4170-4174.doi: 10.3969/j.issn.2095-4344.1352

Previous Articles     Next Articles

Early versus late reconstruction of anterior cruciate ligament with tendon autografts under arthroscopy

Li Shuzhen1, 2, Wang Hao2, Han Jie2, Liang Haibo2, Qin Zhi2, Sun Ke1, Yin Dong1
  

  1. 1Department of Orthopedics, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China; 2Department of Orthopedics, Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China
  • Received:2019-04-16
  • Contact: Yin Dong, Department of Orthopedics, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    Self-financing Project of the Health and Family Planning Commission of Guangxi Zhuang Autonomous Region, No. RKP201006 (to LSZ); the Natural Science Foundation of Guangxi Zhuang Autonomous Region, 2017JJA140564z (to LSZ)

PDF

34

Abstract:

BACKGROUND: At present, the surgical timing for repair of acute anterior cruciate ligament injury remains controversial. Some scholars believe that delayed reconstruction will increase joint surface stress and accelerate the degenerative change of the knee joint during long-term motion and suggest early reconstruction of anterior cruciate ligament. Other scholars believe that acute intra-articular hematocele and swelling, inflammatory reaction and joint capsule damage will increase the risk of postoperative knee joint adhesion and stiffness. Therefore, they recommend reconstruction 1 month after injury.
OBJECTIVE: To investigate the clinical effects of early versus later anterior cruciate ligament reconstruction.
METHODS: Eighty-three patients with anterior cruciate ligament injury, consisting of 48 males and 35 females, who received treatment during January 2014-December 2015 in Ruikang Hospital, Guangxi University of Chinese Medicine, China were included in this study. Among these patients, 37 patients selected autologous hamstring tendon anterior cruciate ligament reconstruction at ≤ 6 weeks after injury (early reconstruction group) and 46 patients selected autologous hamstring tendon anterior cruciate ligament reconstruction at > 6 weeks after surgery (late reconstruction group). After surgery, articular cartilage and meniscus injury were observed under arthroscopy. Joint stability (Lachman test, pivot shift test) and recovery of joint function (hip joint International Knee Documentation Committee score, Lysholm score, limited degree of knee extension and flexion, time spent in recovery of normal range of motion of knee joint) were evaluated. This study was approved by the Ethics Committee of Ruikang Hospital, Guangxi University of Chinese Medicine, China.
RESULTS AND CONCLUSION: Cartilage injury occurred in 7 cases in the early reconstruction group and 15 cases in the late reconstruction group. Meniscus injury occurred in 20 cases in the early reconstruction group and 26 cases in the late reconstruction group. There were no significant differences in the incidence, location and severity of cartilage injury between the early reconstruction and late reconstruction groups (P > 0.05). There were no significant differences in the location and incidence of meniscus injury between these two groups (P > 0.05). There were 11 cases of meniscus resection and 9 cases of meniscus suture in the early reconstruction group. There were 22 cases of meniscus resection and 4 cases of meniscus suture in the late reconstruction group. No significant difference was found in Lachman test and pivot shift test results (P > 0.05). There were no significant differences in International Knee Documentation Committee score, Lysholm score and limited degree of knee extension and flexion between early and late construction groups (P > 0.05). The time spent in recovering normal range of motion of knee joint in the late reconstruction group was shorter than that in the early reconstruction group (P < 0.05). These results suggest that early and late anterior cruciate ligament reconstruction can achieve the same clinical effect, but early reconstruction can increase the probability of meniscus healing.

Key words: tendon autografts, anterior cruciate ligament reconstruction, time factor, arthroscopy, stability, function, meniscus injury

CLC Number: