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Master Thesis

Résultats fonctionnels et IRM des ligamentoplasties bicroisées chez 35 patients à 7.5 ans de suivi, associant une autogreffe par DIDT et un ligament prothétique LARS

Abstract : Purpose: The aim of this study was to evaluate the long-term functional and MRI results of patients who underwent bicruciate ligament reconstruction combining an ACL autograft with gracilis and semitendinosus tendon and double-bundle PCL reconstruction using the LARS artificial ligament. Methods: The outcomes-measures used were the Lysholm score, the Tegner activity level scale and the International Knee Documentation Committee form (IKDC 2000). KT-1000 was used to assess the clinical knee laxity. Radiographs and Magnetic Resonance Imaging (MRI) were used to evaluate osteoarthritis, the continuity and integrity of ACL autograft and LARS. Results: This retrospective study examined 35 patients who underwent single-stage bicruciate ligament reconstruction between May 2005 and January 2017 with a follow-up period ranging from 3 years to 15 years (a mean of 7.5 years). The mean Lysholm score was 74, mean IKDC 2000 was 71. There was a statistically significant difference with a higher Lysholm score (78.9) in early versus delayed surgical intervention (p=0.023). Using the Kellgren Lawrence osteoarthritis classification system, radiographic findings showed stage II or III in 83% of sample population. The MRI results revealed a rupture rate of 22% of the anterior autografted ligament and 28% of the posterior LARS artificial ligament. However, there were no long-term artificial ligament-induced complications. There was no correlation between artificial ligament rupture and poor functional results (Lysholm <65). Conclusion: The results of this study with a mean follow-up of 7.5 years show satisfactory functional scores considering the initial trauma. It seems reasonable to propose an early surgical treatment by a double reconstruction of the cruciate ligaments within the first 21 days of the trauma. Post-traumatic osteoarthritis is widespread in multi-ligament knee injuries despite anatomical reconstruction. The use of a LARS artificial ligament appears to be a valid alternative for PCL reconstruction in the context of multi-ligament injury and in the absence of sufficient autologous transplants.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03358705
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Wednesday, September 29, 2021 - 3:20:38 PM
Last modification on : Friday, October 1, 2021 - 3:23:50 AM

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  • HAL Id : dumas-03358705, version 1

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Valentin Merle Du Bourg. Résultats fonctionnels et IRM des ligamentoplasties bicroisées chez 35 patients à 7.5 ans de suivi, associant une autogreffe par DIDT et un ligament prothétique LARS. Médecine humaine et pathologie. 2021. ⟨dumas-03358705⟩

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