METHOD OF PREPARATION AND INSTALLATION OF FOUR-BEAM AUTOGRAFT FROM TENDON OF SEMITENDINOUS MUSCLE WITH ANTERIOR CRUCIATE LIGAMENT PLASTIC Russian patent published in 2018 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine, namely to traumatology and orthopedics, and is intended for use in plastics of anterior cruciate ligament with autograft from the tendon of the semitendinous muscle. Plasticity of the anterior cruciate ligament is characterized by the installation of a four-beam autograft from the tendon of the semitendinous muscle in the bone tunnels of the knee joint, prepared as follows. First four-bundle transplant is formed from the tendon of semitendinous muscle, for which the ends of the tendon are first stitched together to form a two-beam graft. One of the ends of the resulting two-beam graft is rotated by 180° relative to the other end to obtain a figure in the form of a digit 8 and then aligning the ends to form a four-beam graft. Then four pairs of joints are formed in obtained four-graft transplant with help of separate threads. In this case, the first pair of seams are formed from the distal and proximal ends of the graft, threading the loops formed by the bundles of the tendon, for subsequent transplantation through the tibial and femoral tunnels and its temporary tension in the process of plastic surgery; second pair is the proximal and distal circular sutures that are formed at a distance of not less than 2 cm from the ends of the graft by sewing the transverse seam of the transplant bundle, then grafting the graft and forming the node between the ends of the strands; third pair of sutures is formed near the proximal and distal circular sutures from the central part of the graft to provide the final cortical fixation of the graft on the femur and tibia, respectively, for which grafting of the graft is performed through two bundles of the tendon located in a diagonal cross-section; the fourth pair of “crimping” sutures is formed at the ends of the graft in such a way that when the threads are stretched during plastics, diameter of the distal and proximal ends of the graft is increased by at least 20 %. After preparation of the autograft, the anterior cruciate ligament is plasticized. Transplant is pulled through tibial and femoral tunnels by pulling proximal filament, which is threaded into a loop formed by bundles of tendon. Simultaneously, pulling is done for proximal thread fixed to one of the holes of the cortical retainer. Proximal thread that is threaded into loop formed by the tendon bundles is removed. Due to thrust of the distal thread, passed into the loop formed by the tendon bundles, the graft tension and final placement of the femoral cortical retainer on the external surface of the femur are performed. Cords of proximal corrugating suture are tied over cortical tibial retainer after preliminary sipping. Over cortical tibial fixator, the strings are tied with a constant tension for the final distal cortical fixation. Remove distal thread, threaded into a loop formed by bundles of the tendon. Above cortical tibial retainer, the strands of the distal corrugating suture are tied after preliminary sipping.

EFFECT: invention by reducing trauma of donor area can reduce the number of complications in patients after plastic surgery, as well as by preventing the expansion of bone tunnels, reduce the number of stages of revision operations after plastics of the anterior cruciate ligament with a graft from the tendon of the semitendinous muscle.

5 cl, 6 dwg