Valutazione cimenatica di tre tecniche di ricostruzione di legamento crociato anteriore con sistema di navigazione intraoperatorio

In the setting of an Anterior Cruciate Ligament (ACL) injury the gold standard surgical approach is the Single-Bundle (SB) ACL reconstruction technique. Different techniques have been proposed in order to reduce post-operative residual laxity such as Signle Bundle Lateral Plasty (SBLP) reconstruction and Double Bundle (DB) procedures. Forty-two patients undergoing ACL reconstruction were prospectively included in the study. A randomization was performed to allocate the patients in the different study groups: Single-Bundle-Lateral-Plasty, Single-Bundle and Double-Bundle procedures. An intraoperative navigation system was used to evaluate laxity values. Pre and post-surgical reconstruction Lachman test (AP30), Drawer test (AP90), Varus-Valgus stress test at 0° and 30° knee flexion (VV0, VV30), Internal-External rotation (IE30, IE90), and pivot shift (PS) test were the clinical test executed for the laxity evaluation. The reduction of laxity was defined as the difference between laxity before and just after fixation of the graft. In all the three groups, the post-reconstruction laxity values were statistically reduced compared to the pre-reconstruction (P < 0.05) for all the analyzed tests. Considering the analysis of the Drawer test and Internal-External rotation at 30° and 90° of knee flexion, a significant difference was identified among the different surgical reconstructions. The SBLP technique resulted to have the highest reduction values compared to SB (PIE90 = 0.001) and DB (PAP90 = 0.012; PIE30 = 0.021; PIE90 = 0.003) techniques. The SBLP technique performed significantly better compared the other studied techniques in terms of antero-posterior and internal-external laxity reduction at time-zero after ACL reconstruction.