Rimtautas Gudas, Eimantas Spitrys
The anterior cruciate ligament (ACL) is important and the primary stabilizing structure of the knee. ACL is the most commonly injured knee ligament and can cause significant morbidity in all age groups. During this study we are going to analyze what type of traumas most commonly causes primary and repeated anterior cruciate ligament injuries, what transplants and their diameters were used during reconstruction operations and repeated ACL injuries depending on gender and knee side. Results. The average age of analyzed patients was 33.3±13.10. Distribution of ruptures between genders was: women 23.3%, men – 76.7% of cases. It was established that men had ACL repeated rupture significantly more often than women (p<0.05). Left side ruptures were 43.7% of the cases and right 56.3%. It was established that the injury sides distribution difference was not statistically significant (p>0.05). Initial ACL rupture causes 91.3% of the cases was non-contact traumas and 8.7% was contact traumas. Repeated ACL rupture causes 85.4% was non-contact traumas and 14.6% was contact traumas. Statistically significant difference was found (p<0.05), noncontact injuries were more frequent in both initial and repeated ruptures. Primary ACL reconstructive surgery was done 22.3 % of the cases with proprium patella ligament transplant and 77.7% of the cases with semitendinosus-gracilis tendon transplant. Revision surgery was done 72.8% of the cases with proprium patella ligament transplant, 20.4% semitendinosus- gracilis tendon transplant and 6.8% of the cases other types of transplants were used for reconstruction. It was established that primary ligament reconstructive surgery was performed statistically significantly more frequently with semitendinosusgracilis tendon (p<0.05) and revision surgery with proprium patella ligament (p<0.05). Average transplants diameters used during primary ACL reconstructive surgery: semitendinosus – gracilis tendon 7.98±0.62 mm, proprium patella ligament 8.34±1.17 mm. Transplants average diameters used during revision surgery: semitendinosus-gracilis tendon 8.78 ±1.27 mm, proprium patella ligament 10.11±0.85 mm, other transplants 9.42±0.78 mm. The average difference of transplants diameters between the primary and revision reconstructive surgeries was 1.73 ±1.39 mm. Diameters difference between men and women was compared and no statistically significant differences were found (p>0.05). Conclusions. Repeated ACL rupture was more common among men. Primary and secondary ACL ruptures happened more often during non-contact injury. No statistically significant difference between the sides of injury was found, both left and right violations occur at the same rate. Most commonly used transplant for the first ACL reconstruction was semitendinosus – gracilis tendon, for revision – patella proprium ligament transplant. During revision surgeries average 1.73 mm thicker transplants were used compared to primary reconstruction surgery.
Keyword(s): anterior cruciate ligament injuries; anterior cruciate ligament repeated rupture; repeated anterior cruciate ligament injuries dependence on gender; transplants and their diameters difference used for repeated anterior cruciate ligament rupture reconstruc
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