Section of Orthopaedic Surgery, University of Manitoba, AD4-820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada.
Knee Surg Sports Traumatol Arthrosc. 2012 Aug;20(8):1520-7. doi: 10.1007/s00167-011-1735-2. Epub 2011 Nov 3.
The aim of this study was to examine clinical and patient-reported outcomes as well as return to sport in athletes younger than 25 following ACL reconstruction with either bone-patellar tendon-bone (BTB) or hamstring (HS) autografts using a matched-pairs case-control experimental design.
Twenty-three matched pairs were obtained based on gender (57% women), age (18 ± 3 years BTB vs. 18 ± 3 HS), and length of follow-up (5 ± 2 years BTB vs. 4 ± 2 HS). Patients reported participating in very strenuous (soccer, basketball, etc.) or strenuous (skiing, tennis, etc.) sporting activity 4-7 times/week prior to their knee injury. Patient-reported outcomes included return to play data, the IKDC, SAS, ADLS, and SF-36 forms. Clinical outcomes included knee range of motion, laxity, and hop/jump testing.
The majority of patients in both groups were able to participate in very strenuous or strenuous sporting activity 4-7 times per week following surgery [17 (74%) BTB vs. 16 (70%) HS]. However, only 13 (57%) of the BTB subjects and 10 (44%) of the HS patients were able to return to pre-injury activity levels (P = n.s.). HS patients showed higher ADLS (P < 0.01) and SAS (P < 0.01) scores, better restoration of extension (P < 0.05), and less radiographic evidence of osteoarthritis (P < 0.05).
Hamstring and bone-patellar tendon-bone autografts allow approximately 70% of young athletes to return to some degree of strenuous or very strenuous sporting activity, while only approximately half of patients were able to return to their pre-injury sporting activity level. Hamstring grafts lead to better preservation of extension, higher patient-reported outcome scores, and less radiographic evidence of osteoarthritis.
Therapeutic (case-control study) Level III.
本研究采用配对病例对照实验设计，旨在检查年龄在 25 岁以下的 ACL 重建患者使用骨-髌腱-骨（BTB）或腘绳肌（HS）自体移植物后的临床和患者报告结果以及重返运动情况。
根据性别（57%女性）、年龄（BTB 为 18±3 岁，HS 为 18±3 岁）和随访时间（BTB 为 5±2 年，HS 为 4±2 年），获得了 23 对匹配的患者。患者报告在膝伤前每周进行 4-7 次非常剧烈（足球、篮球等）或剧烈（滑雪、网球等）运动。患者报告的结果包括重返运动数据、IKDC、SAS、ADLS 和 SF-36 表格。临床结果包括膝关节活动范围、松弛度和跳跃测试。
两组中大多数患者在手术后都能够每周进行 4-7 次非常剧烈或剧烈的运动[BTB 组为 17（74%），HS 组为 16（70%）]。然而，只有 13 名（57%）BTB 受试者和 10 名（44%）HS 患者能够恢复到受伤前的活动水平（P=无统计学意义）。HS 患者的 ADLS（P<0.01）和 SAS（P<0.01）评分较高，伸展恢复较好（P<0.05），且放射学证据的骨关节炎较少（P<0.05）。
腘绳肌和骨-髌腱-骨自体移植物允许大约 70%的年轻运动员恢复到某种程度的剧烈或非常剧烈的运动，但只有大约一半的患者能够恢复到受伤前的运动水平。腘绳肌移植物可更好地保持伸展，提高患者报告的结果评分，并减少放射学证据的骨关节炎。
治疗（病例对照研究）III 级。
