Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, 100 Tz-You 1st Road, Kaohsiung, Taiwan.
Arch Orthop Trauma Surg. 2013 Apr;133(4):523-30. doi: 10.1007/s00402-013-1679-8. Epub 2013 Jan 24.
The purpose of this study was to compare the outcomes of arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction using autologous patellar tendon and hamstring tendon grafts.
From 1998 to 2007, 59 patients with symptomatic isolated posterior cruciate ligament injury were included in this retrospective study. Twenty-five knees were reconstructed using bone-patellar tendon-bone graft, and 34 knees were reconstructed using hamstring graft. In both groups, surgical techniques were similar, except material of fixation screws. Patients were evaluated pre-operatively and post-operatively at the latest follow-up with several parameters, including symptoms, physical examination, outcome satisfaction, functional scores, radiography and complications.
Average follow-up period was 51.6 months in patellar tendon group and 51.1 months in hamstring tendon group. Significantly more kneeling pain (32 vs. 3 %), squatting pain (24 vs. 3 %), anterior knee pain (36 vs. 3 %), posterior drawer laxity and osteoarthritic change were shown in patellar tendon group than in hamstring tendon group post-operatively. No significant differences were found in other parameters between both groups.
Several shortcomings, including anterior knee pain, squatting pain, kneeling pain and osteoarthritic change, have to be concerned when using patellar tendon autograft. In conclusion, hamstring tendon autograft may be a better choice for transtibial tunnel PCL reconstruction.
本研究旨在比较采用自体髌腱和腘绳肌腱移植物行关节镜下经胫骨单束后交叉韧带重建的疗效。
1998 年至 2007 年,本回顾性研究纳入了 59 例症状性孤立性后交叉韧带损伤患者。其中 25 例膝关节采用骨-髌腱-骨移植物重建,34 例膝关节采用腘绳肌腱移植物重建。两组的手术技术相似,只是固定螺钉的材料不同。患者在术前和末次随访时进行了包括症状、体格检查、疗效满意度、功能评分、影像学和并发症等多个参数的评估。
髌腱组的平均随访时间为 51.6 个月,腘绳肌腱组为 51.1 个月。髌腱组术后出现明显更多的屈膝疼痛(32%比 3%)、深蹲疼痛(24%比 3%)、前膝疼痛(36%比 3%)、后抽屉松弛和骨关节炎改变。两组其他参数无显著差异。
当使用髌腱自体移植物时,需要关注几个缺点,包括前膝疼痛、深蹲疼痛、屈膝疼痛和骨关节炎改变。总之,腘绳肌腱自体移植物可能是经胫骨隧道后交叉韧带重建的更好选择。