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.	姚建華, 李海鵬, 黃炎, 等. 急性前交叉韌帶損傷合并內側副韌帶損傷的治療選擇. 軍醫進修學院學報, 2011, 32(8): 801-802.
2.	曹紅彬, 梁軍, 辛景義, 等. 腓骨長肌重建治療前交叉韌帶損傷. 中華醫學雜志, 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.	陳百成, 張慶民, 馮建剛, 等. 自體中 1/3 髕韌帶重建前十字韌帶術后膝關節內并發癥的探討. 中華骨科雜志, 2000, 20(4): 216-218.
7.	連海云, 羅建成, 王波, 等. 關節鏡下腘繩肌腱重建膝關節前交叉韌帶損傷的臨床研究. 實用骨科雜志, 2012, 18(6): 558-560.
8.	左立新, 高雁卿, 楊衛兵, 等. 腓骨長肌腱移植后對足弓的影響. 中國矯形外科雜志, 2009, 17(15): 1198-1199.
9.	史福東, 馮世慶, 左金增, 等. 關節鏡下自體腓骨長肌腱和腘繩肌腱重建前交叉韌帶的對比. 中華實驗外科雜志, 2014, 31(11): 2531-2533.
10.	左立新, 高雁卿, 楊衛兵, 等. 關節鏡下腓骨長肌腱移植重建交叉韌帶七例. 中國修復重建外科雜志, 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.	吳市春, 鄭亞才, 嚴康寧, 等. 腓骨長肌腱與腘繩肌腱重建前交叉韌帶的療效比較. 中國修復重建外科雜志, 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.	馮會威, 黃迅悟, 孫繼桐, 等. 關節鏡下應用帶跟骨異體跟腱聯合重建前交叉韌帶及內側副韌帶. 現代生物醫學進展, 2013, 13(13): 2472-2475.
20.	錢雪梅, 董偉強, 劉素霞, 等. 關節鏡下膝關節多發韌帶損傷重建術后的康復護理. 中華關節外科雜志(電子版), 2013, 7(1): 52-55.
21.	祝濤. 關節鏡下前交叉韌帶重建術病人術后功能鍛煉的效果觀察. 全科護理, 2011, 9(13): 1153-1154.
22.	劉德全, 馮華, 洪雷, 等. 急性膝關節多發韌帶損傷的早期治療. 中華骨科雜志, 2003, 23(12): 719-722.

1. 姚建華, 李海鵬, 黃炎, 等. 急性前交叉韌帶損傷合并內側副韌帶損傷的治療選擇. 軍醫進修學院學報, 2011, 32(8): 801-802.
2. 曹紅彬, 梁軍, 辛景義, 等. 腓骨長肌重建治療前交叉韌帶損傷. 中華醫學雜志, 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. 陳百成, 張慶民, 馮建剛, 等. 自體中 1/3 髕韌帶重建前十字韌帶術后膝關節內并發癥的探討. 中華骨科雜志, 2000, 20(4): 216-218.
7. 連海云, 羅建成, 王波, 等. 關節鏡下腘繩肌腱重建膝關節前交叉韌帶損傷的臨床研究. 實用骨科雜志, 2012, 18(6): 558-560.
8. 左立新, 高雁卿, 楊衛兵, 等. 腓骨長肌腱移植后對足弓的影響. 中國矯形外科雜志, 2009, 17(15): 1198-1199.
9. 史福東, 馮世慶, 左金增, 等. 關節鏡下自體腓骨長肌腱和腘繩肌腱重建前交叉韌帶的對比. 中華實驗外科雜志, 2014, 31(11): 2531-2533.
10. 左立新, 高雁卿, 楊衛兵, 等. 關節鏡下腓骨長肌腱移植重建交叉韌帶七例. 中國修復重建外科雜志, 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. 吳市春, 鄭亞才, 嚴康寧, 等. 腓骨長肌腱與腘繩肌腱重建前交叉韌帶的療效比較. 中國修復重建外科雜志, 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. 馮會威, 黃迅悟, 孫繼桐, 等. 關節鏡下應用帶跟骨異體跟腱聯合重建前交叉韌帶及內側副韌帶. 現代生物醫學進展, 2013, 13(13): 2472-2475.
20. 錢雪梅, 董偉強, 劉素霞, 等. 關節鏡下膝關節多發韌帶損傷重建術后的康復護理. 中華關節外科雜志(電子版), 2013, 7(1): 52-55.
21. 祝濤. 關節鏡下前交叉韌帶重建術病人術后功能鍛煉的效果觀察. 全科護理, 2011, 9(13): 1153-1154.
22. 劉德全, 馮華, 洪雷, 等. 急性膝關節多發韌帶損傷的早期治療. 中華骨科雜志, 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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