Abstract
To illustrate our clinical experience of using a complete biological method of fixation in ACL surgery and correlate the histology at the graft and the host bone interface performed in an animal experiment.
Materials: 18 male patients of mean age were 31.2 years (range 18 to 50 years) were operated on. The autogenous graft prepared from lateral part of the quadriceps aponeurosis, part of the patella and ligament leaving distal tibial attachment, passed through the trans-osseous tunnel so that bony part of the graft stay within the femoral tunnel, remaining part was sutured with the iliotibial tract.
Patients began immediate knee exercises with continous-passive-motion devices in the recovery room. With 100 degrees of knee motion, they allowed to bear full weight on the operatively treated limb with knee in a brace in extension
Results: 3 patients had superficial wound infection and 2 had haemarthrosis. None had any laxity or flexion contracture, mean flexion arc was135 (130–145) degree.
Conclusion: Histology of the bone graft and host tunnel confirms full incorporation of the graft in experimental animals performed by our senior author. The procedure of biologic fixation method in ACL reconstruction surgery to preserve the biological integrity of the patellar ligament distally in the tibial end may avoid early failure in fixation method. The biological integration producing a bone block in the femoral tunnel may enable clinician to start early rehabilitation program.
Correspondence should be addressed to Mr Carlos Wigderowitz, Senior Lecturer, University Department of Orthopaedic and Trauma Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY.
