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运动活跃人群中的 ACL 重建:胫骨结节下内移(ST/G)与骨-髌腱-骨(BPTB)胫骨结节前侧入路的对比:初步结果。

ACL reconstruction in sports active people: transtibial DB technique with ST/G vs. transtibial SB technique with BPTB: preliminary results.

机构信息

Sports Traumatology and Arthroscopic Surgery Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.

出版信息

Injury. 2010 Nov;41(11):1168-71. doi: 10.1016/j.injury.2010.09.029. Epub 2010 Oct 8.

DOI:10.1016/j.injury.2010.09.029
PMID:20934698
Abstract

The single-bundle ACL reconstruction ensures good outcomes and it is a well-established and widespread technique. Nevertheless, some patients still present residual pain and instability. Recent studies have showed that the double-bundle technique restores better natural ACL-fitting kinematics. Long-term clinical studies comparing the two surgical techniques are not frequent and there is no instrument to evaluate function and kinematics during the knee rotation in vivo. In this randomised prospective study performed on sportive people, we compare the BPTB single-bundle ACL reconstruction technique, which is the most common surgical technique performed on these patients' category, with the ACL double-bundle reconstruction technique (DB), in order to evaluate possible differences between the groups. Comparing the two groups, no statistically significant difference regarding the post-operative Lysholm score (p=0.368) the Tegner activity scale (p=0.519) and the arthrometric evaluation with KT-1000 (p=0.74) have been observed. On the contrary, the IKDC evaluation showed a statistically significant difference (p=0.004) better results of the DB group. Moreover, as assessed by the Tegner activity scale, only patients of the DB group were able to return to sports at a pre-injury level. Our data suggest that the double bundle ST/G ACL reconstruction technique results into slightly better outcome than the traditional technique of single-bundle BPTB. The verification and quantification of the advantages of this technique is anticipated with future studies focusing to the accurate measurement of knee rotation during different activities.

摘要

单束 ACL 重建可确保良好的结果,并且是一种成熟且广泛应用的技术。然而,仍有一些患者存在残余疼痛和不稳定。最近的研究表明,双束技术可以更好地恢复 ACL 的自然运动学。比较两种手术技术的长期临床研究并不常见,并且没有仪器可以评估体内膝关节旋转过程中的功能和运动学。在这项针对运动员的随机前瞻性研究中,我们比较了最常用于此类患者的髌腱单束 ACL 重建技术(BPTB)与 ACL 双束重建技术(DB),以评估两组之间的可能差异。比较两组后,在术后 Lysholm 评分(p=0.368)、Tegner 活动量表(p=0.519)和 KT-1000 关节测量(p=0.74)方面均无统计学差异。相反,IKDC 评估显示出统计学差异(p=0.004),DB 组的结果更好。此外,根据 Tegner 活动量表评估,只有 DB 组的患者能够恢复到受伤前的运动水平。我们的数据表明,双束 ST/G ACL 重建技术的结果略优于传统的髌腱单束 BPTB 技术。未来的研究将重点关注不同活动中膝关节旋转的精确测量,以验证和量化这种技术的优势。

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