Comparison of the Functional Outcome of Site Peroneus Longus Graft Donors With and Without Distal Stump Suturing of Peroneus Tendon Brevis on ACL Reconstruction Case in Cipto Mangunkusumo Hospital in Jakarta With 24 Patient as Subject Who Will Divide Into 2 Group.
- Conditions
- Rupture of Anterior Cruciate Ligament
- Interventions
- Procedure: Distal Stump Suturing
- Registration Number
- NCT04431063
- Lead Sponsor
- Indonesia University
- Brief Summary
Injury of the Anterior Cruciate Ligament (ACL) is one of the most common sports injuries. The incidence rate reaches 68.6 cases per 100,000 people per year. Management of ACL injuries for individuals who want to return to the level of exercise activity as before, mostly in the form of reconstructive surgery. As many as 60,000 to 175,000 cases of ACL reconstruction per year are carried out in the United States At present, many reconstructive surgeries are performed by taking tendon grafts on the patient's own body (autograft) to then be used instead of the ACL. The most widely used graft sources are Hamstring and Bone-Patellar Tendon-Bone (BPTB) grafts. Other alternative grafts are Quadriceps tendon, Fascia Lata, Iliotibial Band, and Peroneus Longus Tendon. Each graft retrieval technique has advantages and disadvantages. BPTB graft has the best tensile strength and bone union with bone, but the complications of anterior knee pain are also quite common (5-55%). Hamstring grafts and Quadriceps grafts minimize the complications of anterior knee pain, with fairly good tensile strength, but the union of grafts with bone takes longer. The loss of Hamstring tendons also causes a decrease in muscle strength in Hamstring, where Hamstring has an important role in preventing the anterior translation of the tibia Peroneus Longus Tendon graft is an alternative graft developed to minimize complications associated with graft use from the area around the knee. Peroneus Longus tendons also have tensile strength similar to Hamstring tendons.
As with other graft extracts, Peroneus Longus tendon graft is also accompanied by complications in the donor site. Possible complications arising from the loss of the Peroneus Longus tendon include ankle instability and decreased flexion strength of the 1st ray and ankle eversion. Research carried out by Bancha et al showed a reduction in flexion strength of 1st ray and ankle eversion significantly, without any instability in the ankle. Peroneus longus provides 5.5% strength for moderate dorsiflexion for ankle eversion movements, peroneus longus is the main muscle. But in other studies it is said that the use of peroneus longus graft does not interfere with the stability of the ankle and ROM. Does not even affect the functional outcome of the ankle However, in a study conducted by Bancha et al and Kerimoglu et al., The technique used for taking Peroneus Longus graft tendons did not include suturing in the distal stump of Peroneous Longus. So with this study, researchers wanted to find out whether different results would be found related to donor site complications if the technique used included suturing the distal stump of the Peroneus Longus tendon against the peroneus brevis tendon
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 24
- Patients with total ACL rupture using peroneus longus graft
- The suturing procedure for the distal stump peroneus longus against the peroneus brevis tendon is performed by orthopedic specialists or resident chiefs who have been given training in advance.
- Osteoarthtis Knee Kellgren-Lawrence III and IV
- Osteoarthtis Knee Kellgren-Lawrence III and IV
- Flatfoot as evidenced by physical examination and footprinting
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Sutured Stump Distal Stump Suturing The group consist of subject with distal stump suturing of perobeus longus agains peroneus brevis in ACL Reconstruction Case
- Primary Outcome Measures
Name Time Method Six-months postoperative hand dynamometer value This measurement was carried out at 6 months postoperatively Value of objective measurement of the strength of the medial part of the plantarflexion in the one metatarsal head with the hand of the Dynamometer when the patient is supine. The measurement is done 3 times and the value used is the average of the 3 times the measurement. Healthy ankles were also examined as a comparison with the same measurement method. There is no minimum and maximum value, and the higher value the better the outcome
Three-months Clark's Angle Value This measurement was carried out at the 3 months postoperatively the value of the objective angle measurement on the footprint by drawing a line from the medial side of the one metatarsal head and the heel against the second line which is connecting the one metatrsal head and the peak of the medial longitudinal arch. Clarke Angle of \< 31° means there is tendency to flatness and/or pronation. angle of 31° to \< 45° is the normal range. Clarke Angle of \> 45° means there is tendency to cavus foot
Six-months Clark's Angle Value This measurement was carried out at the 6 months postoperatively the value of the objective angle measurement on the footprint by drawing a line from the medial side of the one metatarsal head and the heel against the second line which is connecting the one metatrsal head and the peak of the medial longitudinal arch. Clarke Angle of \< 31° means there is tendency to flatness and/or pronation. angle of 31° to \< 45° is the normal range. Clarke Angle of \> 45° means there is tendency to cavus foot
Preoperative hand dynamometer value This measurement was carried out at the preoperative setting Value of objective measurement of the strength of the medial part of the plantarflexion in the one metatarsal head with the hand of the Dynamometer when the patient is supine. The measurement is done 3 times and the value used is the average of the 3 times the measurement. Healthy ankles were also examined as a comparison with the same measurement method. There is no minimum and maximum value, and the higher value the better the outcome
Three-months postoperative hand dynamometer value This measurement was carried out at 3 months postoperatively Value of objective measurement of the strength of the medial part of the plantarflexion in the one metatarsal head with the hand of the Dynamometer when the patient is supine. The measurement is done 3 times and the value used is the average of the 3 times the measurement. Healthy ankles were also examined as a comparison with the same measurement method. There is no minimum and maximum value, and the higher value the better the outcome
Preoperative Clark's Angle Value This measurement was carried out at the preoperative setting the value of the objective angle measurement on the footprint by drawing a line from the medial side of the one metatarsal head and the heel against the second line which is connecting the one metatrsal head and the peak of the medial longitudinal arch. Clarke Angle of \< 31° means there is tendency to flatness and/or pronation. angle of 31° to \< 45° is the normal range. Clarke Angle of \> 45° means there is tendency to cavus foot
Preoperative the American Orthopedic Foot and Ankle Score (AOFAS) Examination carried out 4 times for each patient in preoperative setting the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AOFAS score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible
Three-months postoperative visual analogue scale foot and ankle (VAS-FA) Examination carried out 4 times for each patient at 3 months postoperatively the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AS-FA score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible
Three months postoperative the American Orthopedic Foot and Ankle Score (AOFAS) Examination carried out 4 times for each patient in 3 months postoperatively the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AOFAS score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible
Six months postoperative the American Orthopedic Foot and Ankle Score (AOFAS) Examination carried out 4 times for each patient in 6 months postoperatively the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AOFAS score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible
Preoperative visual analogue scale foot and ankle (VAS-FA) Examination carried out 4 times for each patient at preoperative setting the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. VAS-FA score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible
Six-months postoperative visual analogue scale foot and ankle (VAS-FA) Examination carried out 4 times for each patient at 6 months postoperatively the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AS-FA score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Cipto Mangunkusumo Hospital
🇮🇩Jakarta, DKI Jakarta, Indonesia