Marks Paul, O'Donnell Siobhan, Yee Gilbert
Department of Orthopaedic Surgery, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Knee. 2008 Jun;15(3):168-73. doi: 10.1016/j.knee.2007.11.004. Epub 2008 Mar 4.
To compare the clinical efficacy of ACL reconstruction using the Mitek bone-tendon-bone cross pin (RIGIDfix) to the Linvatec Bioscrew (control device).
Forty subjects were randomized into one of two groups: the RIGIDfix or control group. Eligible subjects were male and female, 18 years of age and older, with an ACL injury of at least 3 weeks duration and no evidence of ACL insufficiency on the contralateral side. Subjects were followed for 24-month post-operatively. Evaluations included the International Knee Documentation Committee (IKDC) Knee Ligament Standard Evaluation, Mohtadi's ACL Deficiency Quality of Life (ACL-QOL) questionnaire and the attainment of six rehabilitation milestones. Subjects and assessors were blinded to the surgical device used.
Four subjects in the RIGIDfix group and four controls were lost to follow-up. The change in final IKDC scores did not differ significantly between groups with the majority demonstrating an improvement of one to two grades. The change in ACL-QOL scores did not differ significantly between the RIGIDfix subjects (40.0+4.4) and controls (46.0+3.6). Furthermore, the number of weeks that the RIGIDfix subjects versus controls attained full active extension, functional range of motion, normal gait, stair climbing, running gait and sprinting did not differ significantly.
The RIGIDfix results in a similar post-operative course to the control device and is efficacious for the reconstruction of the ACL. No adverse events were associated with the use of the RIGIDfix. The results of this study should be considered preliminary due to the small sample size.
比较使用Mitek骨-肌腱-骨交叉钉(RIGIDfix)与Linvatec生物螺钉(对照装置)进行前交叉韧带(ACL)重建的临床疗效。
40名受试者被随机分为两组之一:RIGIDfix组或对照组。符合条件的受试者为18岁及以上的男性和女性,ACL损伤至少持续3周,对侧无ACL功能不全的证据。术后对受试者进行24个月的随访。评估包括国际膝关节文献委员会(IKDC)膝关节韧带标准评估、莫哈迪的ACL缺陷生活质量(ACL-QOL)问卷以及六个康复里程碑的达成情况。受试者和评估者对所使用的手术装置不知情。
RIGIDfix组有4名受试者和4名对照组受试者失访。两组最终IKDC评分的变化无显著差异,大多数人显示提高了一到两个等级。RIGIDfix组受试者(40.0+4.4)和对照组受试者(46.0+3.6)的ACL-QOL评分变化无显著差异。此外,RIGIDfix组受试者与对照组受试者达到完全主动伸展、功能活动范围、正常步态、爬楼梯、跑步步态和冲刺的周数无显著差异。
RIGIDfix的术后过程与对照装置相似,对ACL重建有效。使用RIGIDfix未出现不良事件。由于样本量小,本研究结果应被视为初步结果。