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ACL 重建术的修正:侧束固定术的影响。

Revision ACL reconstruction: influence of a lateral tenodesis.

机构信息

Department of Orthopaedic Surgery and Sports Traumatology, Service de Chirurgie Orthopédique, L'Archet 2 Hospital, 151 route de St Antoine de Ginestière, 06200, Nice, France.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2012 Aug;20(8):1565-70. doi: 10.1007/s00167-011-1765-9. Epub 2011 Nov 20.

Abstract

PURPOSE

The aims of this article were to report the objective results of revision ACL reconstruction and to assess the influence of an associated lateral extra-articular tenodesis on knee stability and IKDC score.

METHODS

This study focused on revision ACL reconstruction and was conducted over a 10-year period, from 1994 to 2003 with ten French orthopedic centers participating. The minimum follow-up required was 2 years. To be included, patients had to be evaluated at follow-up with the objective International Knee Documenting Committee (IKDC) scoring system. In 2006, 163 patients met the inclusion criteria.

RESULTS

The objective IKDC knee score improved significantly after revision ACL reconstruction, with 72% IKDC A + B (26% A). When a lateral tenodesis was performed, 80% had a negative pivot shift, versus 63% without (P = 0.03), but there was no significant difference in the IKDC score.

CONCLUSION

This study shows a significant improvement in the IKDC score after revision ACL reconstruction. The association of a lateral extra-articular tenodesis with the intra-articular graft increases knee stability after revision ACL reconstruction; however, this additional procedure does not significantly alter the IKDC score at follow-up.

LEVEL OF EVIDENCE

Retrospective case series, Level IV.

摘要

目的

本文旨在报告 ACL 重建翻修的客观结果,并评估联合外侧关节外肌腱固定术对膝关节稳定性和 IKDC 评分的影响。

方法

本研究专注于 ACL 重建翻修,并在 1994 年至 2003 年期间由 10 个法国骨科中心进行了为期 10 年的研究。要求的最低随访时间为 2 年。为了纳入研究,患者必须在随访时使用客观的国际膝关节文献委员会(IKDC)评分系统进行评估。2006 年,有 163 名患者符合纳入标准。

结果

ACL 重建翻修后,客观 IKDC 膝关节评分显著改善,72%为 IKDC A+B(26%为 A)。当进行外侧肌腱固定术时,80%的患者出现阴性枢轴移位,而未行该术式的患者为 63%(P=0.03),但 IKDC 评分无显著差异。

结论

本研究显示 ACL 重建翻修后 IKDC 评分显著提高。联合关节内移植物的外侧关节外肌腱固定术增加了 ACL 重建翻修后的膝关节稳定性;然而,该附加手术在随访时并不会显著改变 IKDC 评分。

证据水平

回顾性病例系列,IV 级。

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