Abstract
Introduction: The use of freeze-dried grafts in the treatment of knee instability is a common technique used in rescue surgery of complex knee instabilities.
Purpose: To assess the evolution of patients that undergo complex knee surgery with freeze-dried ligaments.
Materials and methods: We carried out a retrospective study of patients that had undergone knee ligament surgery with freeze-dried grafts between 1999 and 2005. The study was carried out on 89 patients with a minimum follow-up of 18 months. They were all men except for 3 women. The patients were all of working age, from 19–51 years of age. Fifty-five patients underwent ACL surgery due to tears of previous plasties of the semitendinosus and rectus femoris muscle tendons, with an associated meniscectomy during the first operation in most patients. There were isolated posterior cruciate ligament tears in 5 cases and 29 cases of combined instabilities. In almost all cases preoperative Rh is carried out. Patients were immobilized for a period of 2–4 weeks according to the plasty performed. We assessed the patients using the Lyshom scale, VAS scale, MRI at 1 year, x-rays, range of movement, stability and return to normal work and sports activities.
Results: We assessed the results in patients that underwent ACL rescue surgery and obtained the following results: 44% of the patients reported a subjective feeling of instability and up to 15% required repeat stabilization surgery. In those patients for whom an MRI was obtained it was possible to see 29% of plasty resorption. On x-ray a significant increase in the size of the tibial tunnel and permeability was seen in comparison with autologous series. Good postoperative mobility results were obtained. Seventy percent of the patients were able to return to their previous work activity and 44% continued practicing their customary sports activities. Complications: During the postoperative period recurrent effusions were seen in 41% of the patients, which resolved spontaneously in most cases. There were 2 cases of postoperative septic arthritis that required surgical action.
Conclusions: In our series of freeze-dried plasties we had a high rate of complications and graft resorptions which were clearly higher than those of other published series where other types of grafts were used.
The abstracts were prepared by E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedic Surgery and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología, calle Fernández de los Ríos 108, 28015-Madrid, Spain
