Abstract

Background: Lacerations of anterior cruciate ligament (ACL) ligament in the knee is the supreme cause of ineptitude in sports like athletics, football, volleyball, rugby etc. owing to various multidirectional strain full movements. Bulk of patients electing for surgery to revamp and easy return back to their routine. Despite of their complications like graft rupture, residual laxity, and donor-site morbidity, conventional methods of ACL reconstruction is the gold standard procedure. There is therefore a requirement for further research into newer, innovative surgical techniques which can decrease complication rates. The goals of the ACL reconstruction are to restore stability to the knee; easy return back to regular activities and to delay the onset of osteoarthritis with associated recurrent injuries to the articular cartilage and loss of meniscal functions. This study is to compare the results of ACL Reconstruction using Bone-Patellar-Bone by means of Miniarthrotomy technique.
Materials and Methods: This study was conducted in Narayana Medical College/ Hospital, at from May 2020 to May 2022. During this period 60 cases of adult patients with ACL deficiency were selected according to the inclusion criteria. Prospective Study of ACL Reconstruction using Bone-Patellar-Bone grafts by Miniarthrotomy technique in terms of Post-operative knee stability, Subjective Knee functions, Patient satisfaction, Graft site morbidity, Range of motion. In this study, an effort was made to weigh the advantages over arthroscopic approach.
Results: A total of 60 patients were seen and treated. In the present study mean age group was 28.2 ± 4.5 years. 50.11% of patients were with ACL tear alone, about 65.01% of the study subjects were undertook ACL reconstruction along with part meniscectomy. At the time of 1.5 year follow up, 93.33% had lack of flexion of less than 5 degrees. The anterior drawer’s test during follow up at 1.5 year 98.33% showed 0-2 mm after 1.4 year follow up. The IKDC score at 1.5 year follow up showed predominantly 98.33% patients were fell grade B followed by 5.01% and 1.66% of cases were under grade A and grade C respectively. Lachman’s test at the end of 1.5 years follow up 96.66% subjects showed 0-2 mm displacement and 3.33% showed 3-5mm displacement. At 1.5 year follow up, none of the patients had shown any pathological findings. About 93.33% had shown 90% of functional hop test results and 51.66% of the subjects were with 77 – 90 indicates significant statistical difference between pre and post-operative Lysholm scores. Follow up arthroscopy showed a stable ligament at 1.5 year follow up. While follow up X-ray showed mild arthrosis and few complications like infection, calcification of ligament and arthrofibrosis were observed in one patient.
Conclusion: This study is of clinical relevance as it shows alleviation of pain after surgical treatment of the torn ACL which has been described as the stabiliser of the knee and guardian of the Meniscus. This technique allows achieving good self-reported assessments and clinical ligament evaluation up to 1.5 years. Advantages of this technique include safe clinical practice, enables patients to return to preinjury activities including high-risk sports, unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for revision surgery.