Anatomical anterograde plasty of the anterior cruciate ligament with lateral extraarticular tenodesis from semitendinosus tendon


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Abstract

Purpose of the study: to provide a scientific basis for the recommendations on clinical use of lateral extraarticular tenodesis (LEAT) from semitendinosus tendon (ST) graft as an additional element for knee stability in anterior cruciate ligament (ACL) anatomical anterograde reconstruction. Patients and methods. Treatment results were evaluated for 162 patients (mean age 27.2±2.8) with marked rotational joint instability (Pivot shift test 3+) after arthroscopic anterior cruciate ligament reconstruction (ACL-R). In 44 (27.2%) observations ACL-R was supplemented by LEAT from ST (group 1), in 118 (72.8%) the isolated anatomical anterograde plasty of ACL was performed (group 2). Lysholm Knee Scoring Scale, KOOS and 2000 IKDC were used for the assessment of the results. Results. Follow up period made up at least 2 years. Statistically significant differences between the groups were recorded in 21 months after intervention and later. In 43 (97.7%) patients from the 1group and 111 (94.1%) patients from the 2group excellent and good results (A and B by 2000 IKDC) were achieved. In 1 (2.3%) and 7 (5.9%) patients the results were assessed as satisfactory (C by 2000 IKDC), respectively. No statistically significant differences between the groups were recorded by Lysholm Knee Scoring Scale and 2000 IKDC (p>0.05). The average scores by KOOS that indicated the presence of pathological processes in the knee joint and characterized patient’s sport activity were statistically (p<0.05) better in patients from the 1group. Conclusion. LEAT from ST is a clinically effective supplement to the anatomical anterograde ACL-R in patients with marked rotational joint instability (Pivot shift test 3+) that enables not only to improve the overall knee stability but also to reduce the rate of unfavorable symptoms at follow up terms over 21 months after operation.

About the authors

V. V Zayats

Pavlov First Saint Petersburg State Medical University

Email: zaiatc.vitalii@gmail.com
L’va Tolstogo str., 6-8, Saint Petersburg, 197022, Russia

N. V Zagorodniy

RUDN University

Email: cito@cito-priorov.ru
Miklukho-Maklaya str., 6, Moscow, 117198, Russia

A. K Dulaev

Pavlov First Saint Petersburg State Medical University

L’va Tolstogo str., 6-8, Saint Petersburg, 197022, Russia

A. V Dydykin

Pavlov First Saint Petersburg State Medical University

L’va Tolstogo str., 6-8, Saint Petersburg, 197022, Russia

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