The results of polypropylene mesh application at anterior cruciate ligament reconstruction

Abstract

Anterior cruciate ligament (ACL) repair remains one of the most common surgeries in orthopedics and traumatology. The evolution of the ACL repair technique continues, new fixators appear, and the position of the graft, its shape and size are modified. Semi-tendon and gracilis muscle (STG) grafts are the most common used due to low-trauma and technically simple method of obtaining. Its disadvantage is a long period of intratunnel incorporation, one of the ways of this acceleration is the implantation of a polypropylene mesh. In an experiment on rabbits, we proved its positive effect. Objective. To develop a method of improving the intratunnel incorporation of STG-graft at ACL repair of the knee joint using polypropylene mesh. Methods. Results of 75 patients were analyzed. The study group consisted of 35 patients who underwent surgery during 2018–2019 using polypropylene mesh, comparative group — 40 patients who had surgical treatment in 2017. Evaluated demographic data, pre-operation period, recovery functions, complications rate, data of KOOS and IKDC scales. Results. Non-specific data of the inflammatory process (CRP and ESR) did not change significantly in patients with inserted polypropylene mesh. They did not have more pronounced pain after surgery, there were less cases of reactive synovitis with significantly minimized the number of the knee joint punctures. Restorationof knee function was faster, and early weight bearing of the leg allowed up to 6 months. Better results by the KOOS and IKDC scales received after surgery. Conclusions. Implantation of polypropylene mesh around the intratunnel part of STG-graft at ACL repair surgery did not increase the complications rate and allowed to improve the dynamics of limb function recovery up to 6 months after surgery.