Zaffagnini Stefano, Marcacci Maurilio, Lo Presti Mirco, Giordano Giovanni, Iacono Francesco, Neri Maria Pia
Biomechanics Department, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136 Bologna, Italy.
Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1060-9. doi: 10.1007/s00167-006-0130-x. Epub 2006 Aug 15.
A variety of graft sources have been used for ACL reconstruction to improve functions and kinematics in ACL deficient knees. The two most commonly used autogenous grafts are the central third of the patellar tendon and the hamstring tendon constructs. The choice of different grafts and different construct influence the final clinical outcome of ACL reconstruction. The 3 groups, of 25 patients each, were generated by choosing the technique (PT tendon, 4 strand hamstring, and single hamstring plus extraarticular plasty) to utilize and followed for 5 years, with an alternate systematic sampling. Our comparison has shown significant kneeling pain in the patellar tendon with respect to the groups with hamstrings techniques. Single hamstring plus extraarticular plasty achieved subjective score significantly higher with respect to the other two groups as well as for the time to resume sport. The study confirms that patellar tendon and hamstring can be equivalent options for ACL reconstruction. This study demonstrated that a superior outcome as far as subjective clinical findings were concerned, was obtained in group III. Patients in the latter group were also able to return to sports sooner than those in the bone-patellar tendon graft group and the four-strand hamstring group.
为改善前交叉韧带（ACL）损伤膝关节的功能和运动学，多种移植物来源已被用于ACL重建。两种最常用的自体移植物是髌腱中央三分之一和腘绳肌腱结构。不同移植物和不同结构的选择会影响ACL重建的最终临床结果。通过选择使用的技术（髌腱肌腱、4股腘绳肌和单股腘绳肌加关节外成形术）将患者分为3组，每组25例，并随访5年，采用交替系统抽样。我们的比较显示，与采用腘绳肌技术的组相比，髌腱组存在明显的跪姿疼痛。单股腘绳肌加关节外成形术在主观评分以及恢复运动时间方面均显著高于其他两组。该研究证实，髌腱和腘绳肌可作为ACL重建的等效选择。本研究表明，就主观临床结果而言，第三组取得了更好的结果。后一组患者也比骨-髌腱移植物组和4股腘绳肌组的患者更早恢复运动。
