Laxdal Gauti, Sernert Ninni, Ejerhed Lars, Karlsson Jon, Kartus Jüri T
Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2007 Feb;15(2):115-25. doi: 10.1007/s00167-006-0165-z. Epub 2006 Sep 9.
The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third, bone-patellar tendon-bone (BPTB Group) (n = 45) and four-strand semitendinosus/gracilis (ST/G Group) (n = 78) autografts in male patients. The type of study is non-randomised, prospective consecutive series. A consecutive series of 126 male patients, all with unilateral ACL ruptures, was included in the study. In both groups, interference screw fixation of the graft was used at both ends and 123/126 (97%) of the patients returned for the follow-up examination after a period of 25 (23-33) months. The pre-operative assessments in both groups were similar in terms of the Tegner activity level, the Lysholm knee scoring scale, KT-1000 measurements, one-leg-hop test and knee-walking test. A significant reduction in knee laxity as measured with the KT-1000 arthrometer, compared with the pre-operative assessments, was found in both groups (P < 0.001). No significant differences in the post-operative knee-laxity measurements were found between the groups. Both groups had a significantly improved functional outcome at follow-up in terms of the Lysholm knee scoring scale, Tegner activity level and one-leg-hop test. The BPTB Group had a significantly higher Tegner activity level at follow-up, compared with the ST/G Group (P = 0.02). Moreover, the patients in the BPTB Group were significantly more likely to have a Tegner activity level of 6 or above (P = 0.03). Otherwise, no significant differences were found between the two study groups at the 2-year follow-up. Two years after an ACL reconstruction, the two groups displayed no significant differences in terms of functional outcome and knee laxity. However, more patients in the BPTB Group returned to a higher Tegner activity level than that in the ST/G Group.
本研究旨在比较男性患者采用中央三分之一骨-髌腱-骨（BPTB组，n = 45）和四股半腱肌/股薄肌（ST/G组，n = 78）自体移植物进行关节镜下前交叉韧带（ACL）重建后的结果。研究类型为非随机前瞻性连续系列研究。本研究纳入了连续126例均为单侧ACL断裂的男性患者。两组均采用干涉螺钉在两端固定移植物，126例患者中有123例（97%）在25（23 - 33）个月后返回进行随访检查。两组术前在Tegner活动水平、Lysholm膝关节评分量表、KT - 1000测量、单腿跳测试和膝关节行走测试方面的评估相似。与术前评估相比，两组使用KT - 1000关节测量仪测量的膝关节松弛度均显著降低（P < 0.001）。两组术后膝关节松弛度测量结果无显著差异。两组在随访时Lysholm膝关节评分量表、Tegner活动水平和单腿跳测试方面的功能结局均有显著改善。与ST/G组相比，BPTB组随访时Tegner活动水平显著更高（P = 0.02）。此外，BPTB组患者Tegner活动水平达到6或以上的可能性显著更高（P = 0.03）。否则，在2年随访时两个研究组之间未发现显著差异。ACL重建两年后，两组在功能结局和膝关节松弛度方面无显著差异。然而，BPTB组中恢复到比ST/G组更高Tegner活动水平的患者更多。
