Hubungan Posisi Terowongan Femur dengan Luaran Klinis pada Pasien Paska Rekonstruksi Anterior Krusiata Ligamen di RSUP Haji Adam Malik Medan

Abstract

Background. Injury to the knee is a potentially serious case because the passive stability of the joint can be disrupted. Generally more than one ligament is damaged, but the anterior cruciate ligament (ACL) is the most commonly affected and the most seriously injured. One of the causes of failure in ACL reconstruction is the wrong placement of the femoral tunnel. The purpose of this study was to compare the position of the femoral tunnel with clinical outcomes in patients after anterior cruciate ligament reconstruction. Method. This research is an analytic observational study with a cross sectional approach. The research sample was anterior cruciate ligament rupture patients who underwent anterior cruciate ligament reconstructive surgery at the Department of Orthopaedic and Traumatology at Adam Malik General Hospital Medan who met the inclusion criteria. Clinical outcome evaluation was assessed by quantitative Lysholm scoring, and qualitative examination of the anterior drawer test, Lachman test, and pivot shift test. The results of the research analysis are significant if the p value <0.05. Results. The study sample consisted of 45 people divided into 4 groups, namely the group with the position of the femoral tunnel High-anterior, High-posterior, Low-anterior, and Low-posterior. The data analysis in this study were carried out by qualitative examination in the form of anterior drawer test, Lachman test, pivot shift test and quantitative examination in the form of Lysholm score. The group with the highest number of samples is in the High-anterior position with a total of 20 samples, and the group with the lowest number is in the Low-posterior position with a total of 2 samples. The Lysholm score in the Low-anterior group had the highest score among all groups with an average value of 91 ± 5.3, followed by the High-posterior group with an average score of 90.8 ± 5.6, then the High-anterior group with mean scores of 87.65 ± 13.3, and 85.5 ± 2.5 for the Low-posterior group. The four sample groups showed results that were not statistically significant. Conclusion. Demographically, the most femoral tunnel positions performed at H. Adam Malik General Hospital were in the High-anterior position and the lowest number were in the Low-posterior position, with the highest Lysholm scoring value in the Low-anterior group. However, statistically the position of the femoral tunnel has no significant relationship to the clinical outcome of patients after anterior cruciate ligament reconstruction.