Rupture of anterior cruciate ligament – which implant?
The rupture of the anterior cruciate ligament is amongst the most frequent injuries of the knee joint. Stop and go sports such as football, handball or basketball as well as alpine skiing are the most common cause for this type of injury.There were long-term arguments in numerous studies about the best treatment possible of cross ligament injuries. Therapy concepts (surgical as well as conservative) were continually changing.
According to today’s state of scientific knowledge an anatomically correct reconstruction of the anterior cruciate ligament is necessary in particular in the case of patients who are ambitious in terms of sports. Former suture or re-fixation methods are not applied any longer.
Quadriceps, semitendinosus, gracilis and patella tendon are suitable as transplants for a cruciate ligament reconstruction. Initially, in particular the patella tendon replacement was the preferred choice due to a simpler surgical technique.
In the U.S. alone, more than 100,000 cruciate ligament reconstructions are performed every year. There are ongoing studies and congresses about the use of the implant, the technical procedure regarding the creation of the drill channels as well as the fixation technique.
A study recently published by the ATOS Kliniken in Heidelberg compared with each other the implants currently used in Germany (patella tendon and semitendinosus/gracilis tendon, also called hamstrings, in pressfit technique).
The clinical examination did not show any differences with regard to the extent of stability and mobility. However, the patients’ subjective assessment regarding swelling, pain and feeling of a blockade of the operated knee indicated advantages of the use of the semitendinosus/gracilis tendon. Besides, the functional tests (jumping on one leg from the operated to the healthy leg, kneeling and knee-walking) showed significant advantages in the “hamstring group”. A further highly-significant advantage of the hamstring group was established with regard to the assessment of the state of the cartilage (via control MRT). 23.8% of the patients from the “patella tendon group” showed a deterioration of the cartilage damage as compared with the preoperative diagnostic findings.
In summary both methods produce good results and the patient satisfaction is very high. However, the advantages of using hamstring implants were overall more impressive.
SPORTHOMEDIC is able to offer you both surgery methods and to advise you thoroughly. Please do not hesitate to contact us, we are happy to advise!
