Early plastic surgery of the anterior cruciate ligament: organizational and clinical aspects of treatment in a particular region.

Summary. The work is devoted to the treatment of fresh ruptures of the anterior cruciate ligament by plastic method with adductor tendons in comparison with patients with chronic anteromedial instability of the knee joint.
The aim of the study was to study the effect of the duration of the preoperative period of ACL repair on the results of treatment.
Material and method. A total of 68 patients were selected and included in the study, of which 5 (7.4%) patients were excluded, 63 patients were subjected to statistical analysis, 44 men and 19 women, aged 18 to 45 years, mean age 31.3 ± 3.4 years. Two study groups Group I (main -30 patients) duration from injury to surgery from 8 to 21 days (mean - 16.9±6.3 days), II (control – 33 patients) group from 6 months to 15 months (mean - 11.4±5 ,3 months). According to the mechanism of injury, there were: domestic (fall) 28 patients (44.4%), sports - 35 patients (55.6%) amateur athletes. Average height 178.7±9.4 cm, average weight 76.5±7.8 kg, average body mass index (BMI) 27.3±2.3 kg/m², activity level on the Tegner scale before injury not lower than 5 (1–10).
The study used a 10-point visual analogue pain scale (VAS) and a numerological patient satisfaction scale (NSS), Tegner and Lysholm scales, an anterior drawer test, before and after surgery (after 6 and 12 months).
Results. Pain syndrome after surgery in patients of the first group at 6 months was less than in patients of the second group (group I - 1.6 ± 1.5, group II - 1.9 ± 1.0, p = 0.012), leveled off by 12 months . NSV at 6 months after surgery in group I was 8.2±1.8, significantly exceeding the values of group II (7.4±0.8, p<0.001), while 8 (26.7%) patients assessed to a maximum of 10 points, which was not observed in the control group. The Tegner test at 6 months was statistically significantly reduced compared to the preoperative one in both groups, but there was a statistically significant difference of 9.7% between the groups (p<0.001), but by 12 months after the operation it returned to the pre-injury level and the difference between the groups was absent (group I 6.3±1.0 points, group II 6.2±1.5 at p=0.732). The results on the Lysholm scale in both groups had no statistically significant difference (p=0.683).
Conclusion. Early plastic surgery of the anterior cruciate ligament contributes to a faster recovery of the level of physical activity but requires a change in the system of surgical care.

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