Duplex scanning of veins of the lower limbs and of paraarticular tissues after arthroscopic reconstruction of the anterior cruciate ligament

Aim. Evaluation of paraarticular tissues and of venous outflow by the data of ultrasound duplex scanning (USDS) after arthroscopic plasty of the anterior cruciate ligament (ACL).

Materials and Methods. Analysis of the results of examination of 32 patients with ACL injury at the age of 18-50 (mean age 32.62±1.1 years). The technology of transtibial arthroscopic reconstruction of ACL was applied with use of RigidFix and Biointrafix systems of fixation. USDS of veins, paraosseous and paraarticular tissues was performed using «HITACHI» HI Vision Avius device.

Results. The performed studies permitted to reveal a group of patients (with the share of 12%) in whom, by the moment of discharge from hospital to the outpatient treatment, hemodynamic signs of dysfunction of the valves of deepleg veins were recorded. According to sonography data, the volumes of the upper and lateral torsions remained increased, and tissue edema and hematomas along the anteromedial and posteromedial surfaces of the leg persisted. Taking into account the temporary character of these changes withtheir absenceon the follow-up examination after 1.5 months, we think, they were associated with increased traumatization of m. Semitendinosus and m. Gracili due to the anatomical peculiarities of the structure of tendinous-muscular complex (pes anserinum) in certain patients.

Conclusions. The technique of USDS of vein and paraarticular tissue after arthroscopic reconstructionof ACL permits to identify a group of patients at risk for prolongation of rehabilitation period. The dysfunctions of the valves of the deep veinsof legs, the presence of hematomas at the stage of fibrotization require additional rehabilitation measures including medicinal treatment, physical therapy and exercise therapy under control of USDS.