Primena dva tipa suspenzione fiksacije kod rekonstrukcije prednje ukrštene veze semitendinozus-gracilis graftom – randomizirana prospektivna studija
Sažetak
Uvod/Cilj. Oštećenje prednje ukrštene veze kolena je najčešća povreda ligamenata koje zahteva operativno lečenje. Do sada je opisano više tehnika rekonstrukcije prednje ukrštene veze raznim tipovima graftova i implantanata kojima se graftovi fiksiraju. Cilj rada bio je da se uporede dve različite tenike rekonstrukcije prednje ukrštene veze korišćenjem dva tipa implantata za suspenzionu fiksaciju grafta u femoralnom tunelu. Metode. Ovom randomizovanom, prospektivnom studijom obuhvaćeno je 60 pacijenata podvrgnutih rekonstrukciji prednje ukrštene veze u periodu januar 2015–decembar 2017. godine, na Odeljenju za ortopediju i traumatolgiju Vojne bolnice “Doktor Vladan Đorđević” u Nišu. Jednoj polovini pacijenata urađena je fiksacija grafta u femoralnom tunelu implantatom sa fiksnom, a drugoj polovini sa promenljivom dužinom omče. Postoperativna stabilnost kolena procenjivana je 24 meseci posle operativnog zahvata Lachman, Lateral Pivot Shift testom, kao i merenjem artrometrom KT 1000. Rezultati. Kod pacijenata kojima je izvršena fiksacija grafta implantatom sa fiksnom dužinom omče srednja vrednost stabilnosti kolena posle operativnog zahvata merena artrometrom KT 1000 iznosila je 1,167 ± 0,780, dok je kod pacijenata sa varijabilnom dužinom omče ista iznosila 1,100 ± 0,894 (p = 0,605). Srednja vrednost International Knee Documentation Committee (IKDC) skora postoperativno za grupu sa fiksnom omčom iznosila je 84,887 ± 9,0207, a kod onih sa promenljivom omčom 88,327 ± 7,302. Srednja vrednost Lysholm skora za grupu pacijenata sa fiksnom omčom je bila 93,50 ± 6,872, a za grupu sa promenljivom dužinom omče 94,00 ± 5,527. Zaključak. Oba implantata se mogu uspešno koristiti prilikom rekonstrukcije prednje ukrštene veze jer su funkcinalni rezultati operativnog lečenja uz njihovo korišćenje pokazala identičan postoperativni rezultat.
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