Kim Sung-Gon, Kurosawa Hisashi, Sakuraba Keishoku, Ikeda Hiroshi, Takazawa Shunji
Department of Orthopaedics, Juntendo University, 2-1-1 Hongo, Tokyo, Japan.
Arch Orthop Trauma Surg. 2006 May;126(4):260-4. doi: 10.1007/s00402-005-0045-x. Epub 2005 Sep 28.
The goal of this study is to establish the influence of tensioning the graft during anterior cruciate ligament (ACL) reconstruction, with a semitendinosus tendon graft, on postoperative stability.
Prospective controlled clinical trial.
Forty-eight patients were randomly allocated to three groups in which three different tensions, 8, 12, or 15 kg force, was applied on the reconstructed ACL during the operation. The patients were observed for 1 year or more after surgery (min. 1 year, max. 2 years 8 months). Clinical outcome was evaluated using the visual analogue scale, anterior knee laxity (using the KT2000 arthrometer) and the torque of the knee extensor.
Postoperatively, the average side-to-side differences in anterior laxity were 1.3 mm in the 8 kg group, 2.1 mm in the 12 kg, and 2.4 mm in the 15 kg group. The visual analogue scale averaged 84, 83, and 79 mm, respectively. There were no significant differences among the three groups. There were also no significant differences between the groups for muscle strength recovery during isokinetic and isometric contraction at 1 year postoperatively.
There were no significant differences among the groups in subjective clinical results, anterior laxity, and knee extensor strength in the ACL reconstructions that used the autogenous semitendinosus tendon graft.
本研究的目的是确定在前交叉韧带(ACL)重建术中使用半腱肌腱移植物时对移植物进行张紧处理对术后稳定性的影响。
前瞻性对照临床试验。
48例患者被随机分为三组,术中对重建的ACL施加三种不同的张力,即8、12或15千克力。术后对患者进行1年或更长时间的观察(最短1年,最长2年8个月)。使用视觉模拟量表、膝关节前向松弛度(使用KT2000关节测量仪)和膝关节伸肌扭矩评估临床结果。
术后,8千克力组的前向松弛度平均左右差值为1.3毫米,12千克力组为2.1毫米,15千克力组为2.4毫米。视觉模拟量表的平均值分别为84、83和79毫米。三组之间无显著差异。术后1年等速和等长收缩时肌肉力量恢复在组间也无显著差异。
在使用自体半腱肌腱移植物进行ACL重建时,主观临床结果、前向松弛度和膝关节伸肌力量在组间无显著差异。