Yasuda K, Ohkoshi Y, Tanabe Y, Kaneda K
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, University Hospital, Sapporo, Japan.
Am J Sports Med. 1992 Jul-Aug;20(4):471-5. doi: 10.1177/036354659202000420.
Anterior cruciate ligament reconstruction using an autologous graft harvested from the central one-third of the patellar and quadriceps tendon was performed in 65 knees of 65 patients who were followed from 3 to 7 years. Mean anterior laxity of both knees was measured before and after surgery in each patient using the Styker Knee Laxity Tester. At 30 degrees of knee flexion, 58 patients (89%) had differences of less than 2.5 mm between the operated and unoperated knees. Quadriceps strength was measured with the Cybex II and was less than 50% of the uninjured knee at 3 months after surgery. In men, quadriceps strength returned to 78% of normal at 1 year and 85% at final followup. These values were equal to the preoperative level. In women, the quadriceps strength at final followup was 70%, significantly lower than preoperative strength. Hamstring strength recovered to equal the normal strength. Although anterior cruciate ligament reconstruction using one-third of the patellar and quadriceps tendon achieves stability, postoperative quadriceps weakness is a disadvantage. This weakness may be caused by impairment of the knee extensor mechanism resulting from harvesting the graft. We do not currently recommend this technique for anterior cruciate ligament reconstruction.
对65例患者的65个膝关节进行了前交叉韧带重建术，采用取自髌腱和股四头肌肌腱中央三分之一的自体移植物，随访时间为3至7年。使用史赛克膝关节松弛度测试仪在每位患者手术前后测量双膝的平均前向松弛度。在膝关节屈曲30度时，58例患者（89%）患侧与健侧膝关节之间的差异小于2.5毫米。使用Cybex II测量股四头肌力量，术后3个月时股四头肌力量小于健侧膝关节的50%。男性患者在术后1年时股四头肌力量恢复至正常水平的78%，末次随访时恢复至85%，这些数值与术前水平相当。女性患者在末次随访时股四头肌力量为70%，显著低于术前力量。腘绳肌力量恢复至与正常力量相当。虽然使用髌腱和股四头肌肌腱的三分之一进行前交叉韧带重建可实现膝关节稳定，但术后股四头肌无力是一个不利因素。这种无力可能是由于获取移植物导致膝关节伸肌机制受损所致。我们目前不推荐将该技术用于前交叉韧带重建。
