Modified exorotation graft tension for tibial fixation in anterior cruciate ligament reconstruction: a randomized controlled trial

Medical Journal of Indonesia

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Title Modified exorotation graft tension for tibial fixation in anterior cruciate ligament reconstruction: a randomized controlled trial
 
Creator Pontoh, Ludwig A.P.; Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia, Fatmawati Hospital, Jakarta
Dilogo, Ismail H.; Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Bardosono, Saptawati; Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Lubis, Andri M.T.; Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Harahap, Alida R.; Eijkman Biomolecular Institute, Jakarta
Pandelaki, Jacub; Department of Radiology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Hidayat, Mohammad; Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar Hospital, Malang
 
Subject ACL reconstruction surgery; anterior cruciate ligament; cartilage oligomeric matrix protein; Kujala score; tibial tubercle trochlear groove
 
Description Background: The inability of anterior cruciate ligament reconstruction (ACLR) surgery to reduce tibial internal rotation causes many problems. A large tibial internal rotation will result in a patellofemoral pain syndrome. This study aimed to introduce a new technique of modified exorotation graft tension at tibial fixation to minimize endorotation, reduce tibial internal rotation, and prevent patellofemoral pain syndrome.Methods: This study was a randomized double-blind controlled clinical trial. ACL rupture patients underwent ACLR surgery between December 2014 and Februrary 2015. They were randomized to standard endorotation group or modified exorotation group. Hamstring autograft was used and fixed with an EndoButtonĀ® and bioabsorbable interference screw. Tibial tubercle to trochlear grove (TTTG) was used to evaluate rotation, whereas cartilage oligomeric matrix protein (COMP) was employed to analyze cartilage breakdown. The functional outcome was measured using the Kujala score to assess patellofemoral joint function. Evaluations were conducted before the surgery and at 6 months postoperation.Results: A total of 29 subjects were recruited. Sixteen subjects were allocated into the standard endorotation group, and 13 were assigned to the modified exorotation group. The exorotation group demonstrated better results than the endorotation group in all three parameters: TTTG (p=0.028), COMP (p<0.001), and Kujala score (p=0.015).Conclusion: A new technique of modified exorotation direction of graft tension for ACL reconstructive surgery at tibial fixation showed a significant reduction in tibial internal rotation and cartilage breakdown. The proposed method could significantly improve the functional outcome of those with total ACL rupture.
 
Publisher Faculty of Medicine Universitas Indonesia
 
Contributor
 
Date 2018-10-12
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion

 
Format application/pdf
 
Identifier http://mji.ui.ac.id/journal/index.php/mji/article/view/1765
10.13181/mji.v27i3.1765
 
Source Medical Journal of Indonesia; Vol 27, No 3 (2018): September; 169-77
2252-8083
0853-1773
10.13181/mji.v27i3
 
Language eng
 
Relation http://mji.ui.ac.id/journal/index.php/mji/article/view/1765/1244
 
Rights Copyright (c) 2018 Ludwig A.P. Pontoh, Ismail H. Dilogo, Saptawati Bardosono, Andri M.T. Lubis, Alida R. Harahap, Jacub Pandelaki, Mohammad Hidayat
http://creativecommons.org/licenses/by-nc/4.0
 

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