[Thermal shrinkage of anterior cruciate ligament--if it works?]

Common used method of treatment of anterior cruciate ligament deficiency is reconstructive surgery. But in cases of incomplete tear of ligament or graft failure one of the treatment options is thermal shrinkage of remain tissue. Although this method is widespread among clinicians, still there are a lot of controversies. Some studies showed good short and midterms outcomes, but others authors described failure of this method in long term observations in form of secondary laxation of the ligament or its spontaneous rupture. The aim of this study was to investigate outcomes of thermal shrinkage of lax, partially torn anterior cruciate ligament or its graft.

In years 2006-2012 was conducted twenty five operations of thermal shrinkage of anterior cruciate ligament or its graft. Full data was obtained from twenty individuals. Anterior stability was assessed by stabilometric side to side tests with Telos Stress Device and Rolimeter. Patients was asked to complete a Lysholm questionnaire. Arthritic changes was assessed by X-Ray scans using Lawrence-Kellgren scale. To made a statistic analysis MS Excel was used.

Among twenty individuals failure of treatment was found in eight cases (40%). Remaining twelve patients (60%) at control examination stated that they feel improvement after surgical treatment. Mean Lysholm score was 87 pts and its comparable to other authors investigations. We have to keep in mind that subjective outcome may be affected by associated injuries.

Thermal shrinkage of anterior cruciate ligament may in some cases find a place as a therapeutic option. The effect of shortening the ligament and improvement of the subjective feeling of instability is noticeable in the short term follow-up, but due to reports in the literature, patients require further observation.