Department of Orthopaedics and Sports Medicine, South Hospital, Grenoble University Hospital Center, 38043 Grenoble cedex, France.
Orthop Traumatol Surg Res. 2009 Dec;95(8):606-13. doi: 10.1016/j.otsr.2009.09.011.
The objective of this study was to evaluate the clinical and radiological results of a prospective, continuous series of 105 ACL reconstructions using the STG tendons fixed to the femur by an EndoButton CL, with more than 4 years of follow-up.
The subjective and objective clinical results as well as the radiological results (tunnel enlargement) obtained by a cortical, extra-anatomic femoral fixation are at least equivalent to the results obtained with other types of femoral fixation systems.
One hundred and five patients aged with a mean 26 years (range, 12-56 years) were operated on for an anterior cruciate ligament rupture using the same technique and by the same operator: four-strand STG fixed to the tibia by a double fixation--BioRCI-HA screw and staple--and on the femur by an EndoButton CL (Smith and Nephew). The results were assessed at 6 months, 1 and 2 years and then at a mean follow-up of 51 months, both clinically (IKDC, Lysholm, KT-1000) and radiologically (Telos laximetry, tunnel position, and morphological analysis).
No complications related to the use of the EndoButton were observed. No additional interference screw was necessary. According to the IKDC laxity classification, 91.4% of the patients were classified in category A or B, nine knees (8.6%) were classified C or D. Four failures required revision with a patellar tendon graft. On the final IKDC score, 63 patients (60%) were classified grade A, 37 grade B (35.3%), four grade C (3.8%), and one grade D (0.9%). On the Telos laximetry, 62 patients (59%) had a differential laxity less than or equal to 2 mm. The mean value was 1.8 mm (range, 0-11). Tibial tunnel enlargement was constant; femoral tunnel enlargement was significant (>2 mm) in 27.6% of the knees. No femoral tunnel diameter modification corresponding to the EndoButton passage was observed.
The results of this series are comparable to the results of other series. Its reproducibility and the absence of iatrogenic complications for this femoral EndoButton CL fixation make it a top-choice technique, like the corticocancellous graft procedures, but without their disadvantages. No secondary elongation attributable to the EndoButton CL was observed. This femoral fixation procedure appeared necessary and sufficient to providing good mechanical stability for the graft in the femoral tunnel.
本研究的目的是评估使用 STG 肌腱通过 EndoButton CL 固定在股骨上的 105 例 ACL 重建的前瞻性连续系列的临床和影像学结果，随访时间超过 4 年。
通过皮质、解剖外股骨固定获得的主观和客观临床结果以及影像学结果（隧道扩大）与其他类型的股骨固定系统获得的结果至少相当。
105 名年龄在 12-56 岁之间的患者因前交叉韧带撕裂接受了相同技术和同一手术医生的手术：四股 STG 通过胫骨双固定（BioRCI-HA 螺钉和钉书钉）和股骨上的 EndoButton CL（Smith 和 Nephew）固定。结果在 6 个月、1 年和 2 年进行评估，然后在平均 51 个月的随访时进行临床评估（IKDC、Lysholm、KT-1000）和影像学评估（Telos 松弛度、隧道位置和形态分析）。
未观察到与使用 EndoButton 相关的并发症。不需要额外的干扰螺钉。根据 IKDC 松弛度分类，91.4%的患者被分类为 A 或 B 类，9 个膝关节（8.6%）被分类为 C 或 D 类。4 例失败需要用髌腱移植物进行翻修。在最终的 IKDC 评分中，63 名患者（60%）被分类为 A 级，37 名患者（35.3%）为 B 级，4 名患者（3.8%）为 C 级，1 名患者（0.9%）为 D 级。在 Telos 松弛度方面，62 名患者（59%）的差异松弛度小于或等于 2 毫米。平均为 1.8 毫米（范围，0-11）。胫骨隧道扩大保持不变；27.6%的膝关节股骨隧道扩大显著（>2 毫米）。未观察到与 EndoButton 通道相关的股骨隧道直径变化。
本系列的结果与其他系列的结果相当。其可重复性和这种股骨 EndoButton CL 固定的医源性并发症的缺失使其成为首选技术，就像皮质皮质骨移植物一样，但没有它们的缺点。未观察到归因于 EndoButton CL 的二次伸长。这种股骨固定程序似乎是必要的，足以在股骨隧道中为移植物提供良好的机械稳定性。
