Clinical experience with PDS II augmentation for operative treatment of acute proximal ACL ruptures--2-year follow-up.
The results of prospective anterior cruciate ligament (ACL) refixation in 33 patients with high proximal rupture is reported at 20-28 months' follow-up: mean age was 31.1 +/- 12.5 years. The surgical technique was a specially developed refixation of the ACL using a multiple suture loop (modified Marshall technique) augmented with intra-articular PDS II (polydioxanon, resorbable, Ethicon, Hamburg, Germany) to avoid derangement of blood circulation and to guarantee early functional rehabilitation. All patients were operated on within 7.3 +/- 4.5 days after injury. According to the IKDC evaluation score, 22 patients showed excellent and 10 patients good subjective function. Twenty regained their pre-injury level of activity. Anterior stability was tested manually and by KT-1000 max (Medmetric, San Diego). Twenty-eight patients had a firm end-point, although there was a positive Lachman test in 16 patients. Maximal joint laxity as measured by KT-1000 showed a 1-2 mm, 3-5 mm, 6-10 mm and > 10 mm anterior drawer for 16, 14, 2 and 1 patients, respectively. Twenty-five of the evaluated knee joints had a negative pivot shift test. Three patients had a limited range of motion. The potential advantages of PDS II-augmented refixation of acute proximal ACL ruptures are anatomic reconstruction without destruction of other anatomic structures used as grafts, early functional rehabilitation and possibly better proprioception.
Hehl
G
G
Traumatologic Department of Surgery, University of Ulm, Germany.
Strecker
W
W
Richter
M
M
Kiefer
H
H
Wissmeyer
T
T
D020341:Absorbable Implants; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery*; D016687:Polydioxanone / Q000627:therapeutic use*; D011446:Prospective Studies; D012086:Reoperation; D012421:Rupture; D013536:Suture Techniques
D016687:Polydioxanone