Ververidis A, Verettas D, Kazakos K, Xarchas K, Drosos G, Psillakis Ioannis
Department of Orthopaedic Surgery, Democritus University of Thrace Medical School, Alexandroupolis, Greece.
Arch Orthop Trauma Surg. 2009 Mar;129(3):323-31. doi: 10.1007/s00402-008-0724-5. Epub 2008 Aug 30.
The aim of this study was to determine the outcome of anterior cruciate ligament (ACL) reconstruction using a patellar tendon bone autograft (one bone block technique).
We retrospectively evaluated a case series of patients who had received arthroscopic ACL reconstructions using patellar tendon bone autograft. Fifty-four (54) ACL reconstructions were evaluated at a mean of 38 months (range 25-62 months). Clinical assessment was made using a modified Lysholm score, documentation of International Kappanee Documentation Committee (lKappaDC), the anterior knee pain questionnaire of Shelbourne and Trumper, and by KappaTau-Rolimeter arthrometric analysis. Radiographic assessments were also performed.
Arthrometric analysis showed that 51 knees (94%) were graded Alpha or Beta with a median laxity of 2 mm, postoperatively. The Lysholm score improved postoperatively from 70 to 89. The patellar position in terms of congruence angle did not show any significant change, and the final shortening of the patellar tendon using the Insall-Salvati ratio was 6.07%. Only three patients complained of moderate pain on kneeling, one patient was unable to participate in strenuous works and one patient complained of harvest-site tenderness.
It is concluded that the use of patellar tendon autograft with a single tibial-tubercule bone block and a strip of patellar periosteum have the advantages of being available and comparable in terms of graft size and strength and shows satisfactory results with reduced anterior knee pain.
本研究旨在确定使用髌腱骨自体移植（单骨块技术）进行前交叉韧带（ACL）重建的结果。
我们回顾性评估了一组接受关节镜下ACL重建并使用髌腱骨自体移植的患者病例。对54例ACL重建进行了评估，平均随访时间为38个月（范围25 - 62个月）。使用改良的Lysholm评分、国际膝关节文献委员会（IKDC）的记录、Shelbourne和Trumper的前膝疼痛问卷以及KappaTau - 关节测径仪进行关节测量分析来进行临床评估。还进行了影像学评估。
关节测量分析显示，术后51个膝关节（94%）评分为Alpha或Beta级，中位松弛度为2毫米。Lysholm评分术后从70分提高到89分。髌骨位置在一致性角度方面未显示任何显著变化，使用Insall - Salvati比率计算的髌腱最终缩短率为6.07%。只有3例患者抱怨跪立时中度疼痛，1例患者无法参加剧烈工作，1例患者抱怨取骨部位压痛。
得出的结论是，使用带有单个胫骨结节骨块和一条髌腱骨膜的髌腱自体移植具有取材方便、移植物大小和强度相当的优点，并且在前膝疼痛减轻方面显示出令人满意的结果。
