Soon M, Neo C P C, Mitra A K, Tay B K
Department of Orthopaedic Surgery, Alexandra Hospital, Singapore.
Ann Acad Med Singap. 2004 Mar;33(2):214-9.
As anterior cruciate ligament (ACL) reconstruction becomes more frequently performed, the expectation of earlier return to activities becomes higher; hence graft selection becomes more important. The use of hamstring tendon autograft is perceived to have less postoperative morbidities. We evaluate the early postoperative complications in this prospective study.
Seventy-six patients operated by the same surgeon were assessed preoperatively, and 3 and 6 months after surgery. The hamstring and quadriceps strength were measured with Biodex machine and the side-to-side laxity measured using KT-1000 instrument. The patients were also assessed for their subjective complaints using IKDC (International Knee Documentation Committee) Knee Scoring System.
The strength and endurance index of the quadriceps and hamstrings recovered and improved by the sixth month after surgery. The recovery by the quadriceps muscle is more marked and by the sixth month, it has recovered to more than the preoperative level. As for laxity, the average side-to-side difference at 30 pounds was 2.75 mm by 6 months. Of these patients, the side-to-side difference was less than 5 mm in 66 patients (5 mm as taken to be acceptable for graft success). As for IKDC rating, at the sixth month, 71 patients had normal or near normal knee by their own assessment. No patients had anterior knee pain at rest. Sensory deficits were only present in 3 patients with complaints of numbness over the distribution of the saphenous nerve or its infrapatellar branch.
Most morbidities are temporal in nature and do not significantly affect the patient's activities.
随着前交叉韧带(ACL)重建手术的开展日益频繁,人们对更早恢复活动的期望也越来越高;因此,移植物的选择变得更为重要。腘绳肌腱自体移植物被认为术后发病率较低。我们在这项前瞻性研究中评估了术后早期并发症。
对由同一位外科医生实施手术的76例患者进行术前、术后3个月和6个月的评估。使用Biodex机器测量腘绳肌和股四头肌力量,使用KT-1000仪器测量两侧的松弛度。还使用国际膝关节文献委员会(IKDC)膝关节评分系统对患者的主观症状进行评估。
股四头肌和腘绳肌的力量和耐力指数在术后第六个月恢复并有所改善。股四头肌的恢复更为明显,到第六个月时,已恢复到超过术前水平。至于松弛度,6个月时30磅力下两侧平均差异为2.75毫米。在这些患者中,66例患者(移植物成功的可接受差异为5毫米)两侧差异小于5毫米。至于IKDC评分,在第六个月时,71例患者自我评估膝关节正常或接近正常。没有患者静息时出现前膝疼痛。感觉障碍仅出现在3例患者中,这些患者主诉隐神经或其髌下支分布区域麻木。
大多数并发症是暂时的,不会对患者的活动产生显著影响。