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自体腘绳肌腱移植与新鲜冷冻异体胫后肌腱移植用于初次关节镜下前交叉韧带重建的比较:一项随访3至6年的回顾性队列研究

Hamstring tendon autograft versus fresh-frozen tibialis posterior allograft in primary arthroscopic anterior cruciate ligament reconstruction: a retrospective cohort study with three to six years follow-up.

作者信息

Mardani-Kivi Mohsen, Karimi-Mobarakeh Mahmoud, Keyhani Sohrab, Saheb-Ekhtiari Khashayar, Hashemi-Motlagh Keyvan, Sarvi Ali

机构信息

Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Orthopaedic Department, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

Int Orthop. 2016 Sep;40(9):1905-11. doi: 10.1007/s00264-016-3164-9. Epub 2016 Mar 18.

Abstract

INTRODUCTION

Selection of various grafts for anterior cruciate ligament (ACL) reconstructions have been employed in order to improve on stability and function of the knee. This study aimed to compare stability and function of the knee after ACL arthroscopic reconstruction by single-loop tibialis posterior (TP) allograft and four-strand hamstring tendon (HT) autograft.

MATERIALS AND METHODS

The retrospective cohort study included 104 patients in the TP group matched with 118 patients in the HT group in terms of demographic characteristics, associated meniscus injury, subjective and objective knee characteristics. All patients were followed up for at least three years with regards to mentioned criteria and time of return to former activities.

RESULTS

The mean (range) age of TP (88 males and 16 females) and HT (99 males and 19 females) groups was 34.4 (19-48) and 36.9 (20-51) years, respectively. Median (range) follow-up durations were 55 (37-71) and 56 (36-72) months, respectively. No significant differences were observed post-operatively, regarding subjective and objective evaluations. Additionally, time duration for return to former activity was similar in both groups. Post-operative paresthesia and numbness of medial aspect of the calf were observed for two months in eight patients of the HT group which persisted to the final visit in one case. No similar symptom was seen in the TP group.

CONCLUSION

In arthroscopic ACL reconstruction, fresh frozen doubled TP allograft compared to HT autograft was equally effective in restoring function and stability of knee, permitting return to former activities.

LEVEL OF EVIDENCE

Retrospective comparative, Level III.

摘要

引言

为了改善膝关节的稳定性和功能,人们采用了多种移植物进行前交叉韧带(ACL)重建。本研究旨在比较单环胫后肌(TP)同种异体移植物和四股腘绳肌腱(HT)自体移植物在关节镜下ACL重建术后膝关节的稳定性和功能。

材料与方法

这项回顾性队列研究纳入了104例TP组患者,与118例HT组患者在人口统计学特征、相关半月板损伤、主观和客观膝关节特征方面进行匹配。所有患者均按照上述标准和恢复先前活动的时间进行了至少三年的随访。

结果

TP组(88例男性和16例女性)和HT组(99例男性和19例女性)的平均(范围)年龄分别为34.4(19 - 48)岁和36.9(20 - 51)岁。中位(范围)随访时间分别为55(37 - 71)个月和56(36 - 72)个月。在主观和客观评估方面,术后未观察到显著差异。此外,两组恢复先前活动的时间相似。HT组有8例患者术后出现小腿内侧感觉异常和麻木,持续两个月,其中1例持续至最后一次随访。TP组未观察到类似症状。

结论

在关节镜下ACL重建中,与HT自体移植物相比,新鲜冷冻双股TP同种异体移植物在恢复膝关节功能和稳定性、允许恢复先前活动方面同样有效。

证据水平

回顾性比较,三级。

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