Gifstad Tone, Drogset Jon Olav, Grøntvedt Torbjørn, Hortemo Grete Sofie
Orthopaedic Research Center, Trondheim University Hospital, 7006, Trondheim, Norway,
Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2153-62. doi: 10.1007/s00167-013-2652-3. Epub 2013 Sep 5.
Hamstring tendon grafts are commonly used in anterior cruciate ligament (ACL) reconstructions. A number of fixation devices are available; however, several have limited clinical support. To our knowledge, no randomized controlled study comparing the EZLoc and the Bone Mulch Screw for femoral fixation in ACL reconstruction exists. Therefore, the purpose of this study was to compare the results following the use of these two femoral fixation devices. Time in surgery for the two methods was also to be compared.
A total of 110 patients between 18 and 45 years old at two orthopaedic departments, A (n = 55) and B (n = 55), were randomized to ACL reconstruction with femoral fixation of the hamstring graft with either the EZLoc or the Bone Mulch Screw. Surgical time was measured for each group. The patients were evaluated after 6 weeks and 3, 6, 12 and 24 months. The clinical examination included range of motion, evaluation of intraarticular swelling, tenderness at the lateral femoral condyle, the Lachman test, the Pivot shift test and the KT-1000 arthrometer. In addition, the visual analogue scale score for pain, the Tegner activity score, the Lysholm functional score and the knee injury and osteoarthritis outcome score were recorded. Knee extension and flexion muscle strength were also measured with a Biodex.
There were no significant differences in any of the parameters mentioned above at the 2-year follow-up evaluation. Three patients in each group underwent revision ACL reconstruction during the study. More than 95% of the knees in both groups were found to be stable. Good to excellent results were found for all selected knee scores in both groups. There were no statistically significant differences between the two groups in any of the muscle strength parameters. Time in surgery was statistically significantly shorter in the EZLoc group compared with the Bone Mulch group.
There were no statistically significant differences in clinical findings, knee scores or in muscle strength between the EZLoc group and the Bone Mulch group at the 2-year follow-up evaluation. Time in surgery was statistically significantly shorter for patients undergoing ACL reconstruction with hamstring grafts when the EZLoc femoral fixation device was used.
II.
腘绳肌腱移植物常用于前交叉韧带（ACL）重建。有多种固定装置可供选择；然而，一些装置的临床支持有限。据我们所知，尚无比较EZLoc和骨碎粒螺钉在ACL重建中用于股骨固定的随机对照研究。因此，本研究的目的是比较使用这两种股骨固定装置后的结果。同时也比较两种方法的手术时间。
两个骨科科室（A科室n = 55例，B科室n = 55例）共110例年龄在18至45岁之间的患者被随机分为两组，分别采用EZLoc或骨碎粒螺钉对腘绳肌腱移植物进行股骨固定来重建ACL。测量每组的手术时间。在术后6周以及3、6、12和24个月对患者进行评估。临床检查包括活动范围、关节内肿胀评估、股骨外侧髁压痛、Lachman试验、轴移试验和KT - 1000关节测角仪检查。此外，记录疼痛的视觉模拟量表评分、Tegner活动评分、Lysholm功能评分以及膝关节损伤和骨关节炎疗效评分。还使用Biodex测量膝关节屈伸肌力。
在2年随访评估中，上述任何参数均无显著差异。每组有3例患者在研究期间接受了ACL翻修重建。两组中超过95%的膝关节被发现是稳定的。两组所有选定的膝关节评分均为良好至优秀结果。两组在任何肌力参数上均无统计学显著差异。与骨碎粒组相比，EZLoc组的手术时间在统计学上显著更短。
在2年随访评估中，EZLoc组和骨碎粒组在临床结果、膝关节评分或肌力方面均无统计学显著差异。使用EZLoc股骨固定装置进行ACL重建时，手术时间在统计学上显著更短。
II级。
