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Background . Currently, work continues to improve the methods of arthroscopic reconstruction of the anterior cruciate ligament with an autograft, aimed at reducing the risk of postoperative failure. Aim of the study . To assess the immediate results of using a new method of preparing an autograft for anterior cruciate ligament plasty. Materials and methods. The analysis of the results of surgical treatment of 28 patients with old complete traumatic rupture of the anterior cruciate ligament, who were treated in the Department of traumatology and orthopedics of the Irkutsk Scientific Center of Surgery and Traumatology, was carried out. The patients were men aged 18 to 40 years. The common thing for all patients was the All-inside arthroscopic plasty of the anterior cruciate ligament. Two groups of patients were formed depending on the method of preparation of the autograft. The first group consisted of 18 patients in whom a well-known technique was used, including the formation of a four-bundle autograft from one tendon of the semitendinosus muscle. In 10 patients of the second group, a new method of preparing an autograft was used, including the stage of preliminary determination of the required length and thickness of the autograft, and the stage of forming an autograft from the tendon of the semitendinosus and gracilis muscles on the common tendon pedicle. Results . Comparative analysis of the immediate results of arthroscopic plasty of the anterior cruciate ligament with an autograft in case of its old complete traumatic injury revealed a significantly lower number of undesirable consequences when using a new method of preparing an autograft. In two cases, persistence of the pain syndrome associated with arthritic changes in the joint was observed, in one patient there was a restriction of movements in the knee joint, no synovitis, a sensation of instability of the knee joint, ruptures and detachments of the autograft were found. All patients were satisfied with the achieved result. Conclusion. A new method of preparing an autograft for plasty of the anterior cruciate ligament allows achieving anatomical reconstruction of the anterior cruciate ligament, optimal function of the knee joint, reducing pain, significantly reducing the risk of developing knee instability, ruptures and abruptions of the autograft in the postoperative period due to an individual approach, increasing the strength of the autograft and the strength of its fixation in the bone canals.

Researches performed in the past 20 years show the necessity of the restoration of anatomic position of anterior cruciate ligament as the main stabilizing structure of the joint in combination with the restoration of other injured elements and correction of deformities, which affect the outcomes of the treatment. Complexity of the restoration of anatomic position of torn anterior cruciate ligament is caused by its wide area of contact in combination with relatively small sectional area through the joint cavity. More detailed study of topographic anatomy of anterior cruciate ligament allowed the researchers to explain this phenomenon, which pushed them closer to the solution of the problem. Systemic anatomy of anterior cruciate ligament include two bundles - anteromedial bundle and posterolateral bundle. Double bundle plasty of anterior cruciate ligament restored anatomy to its nearly normal condition, but single bundle plasty is used much more often because of its simpler technique. However, the researchers still cannot reach a consensus in the choosing of single or double beam plasty at the restoration of anterior cruciate ligament.