Devgan Ashish, Rohilla Rajesh, Singh Amanpreet, Tanwar Milind, Devgan Radhika, Siwach Karan
Department of Orthopaedics, PGIMS, Rohtak, Haryana, India.
GMERS Medical College, Sola, Ahmedabad, India.
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):236-242. doi: 10.1016/j.jcot.2016.01.004. Epub 2016 Feb 13.
The aim of the study was to compare clinical and radiological outcomes of arthroscopic single-bundle versus double-bundle anterior cruciate ligament (ACL) reconstruction.
60 patients with isolated ACL injury were divided into single bundle (SB) ( = 30) and double bundle (DB) reconstruction groups ( = 30) and operated between July 2009 and July 2012. Outcome evaluation was performed using GNRB arthrometer, International Knee Documentation Committee & Lysholm scale. Rotational stability was determined by lateral pivot-shift test. Magnetic resonance imaging (MRI) was performed postoperatively to compare the reconstructed ACL graft orientation.
Average follow-up was 34.8 months in SB and 36.2 months in DB group. At final follow-up, mean Lysholm score was 94.13 ± 2.67 in SB and 93.13 ± 3.31 in DB group ( value = 0.202, statistically non-significant). All patients in both groups were in grade A or B according to objective IKDC scores. Mean differential anterior tibial translation was 1.45 ± 0.6 mm in SB and 1.17 ± 0.8 mm in DB group ( value = 0.105, NS). All had negative pivot shift test in DB group while 2 patients had positive pivot shift in SB group. MRI of operated knees showed that values of mean sagittal ACL graft-tibial angle and mean coronal ACL graft-tibial angle were comparable in both groups ( value > 0.05, NS).
There was no statistically significant difference concerning knee stability, knee scores, subjective evaluations, and MRI evaluation of graft inclination angles between single- and double-bundle ACL reconstruction groups at an average of 35 months of follow-up.
本研究旨在比较关节镜下单束与双束前交叉韧带(ACL)重建的临床和影像学结果。
60例单纯ACL损伤患者被分为单束(SB)组(n = 30)和双束(DB)重建组(n = 30),于2009年7月至2012年7月期间接受手术。使用GNRB关节测量仪、国际膝关节文献委员会(IKDC)及Lysholm量表进行结果评估。通过外侧轴移试验确定旋转稳定性。术后进行磁共振成像(MRI)以比较重建的ACL移植物方向。
SB组平均随访34.8个月,DB组平均随访36.2个月。在末次随访时,SB组Lysholm评分均值为94.13±2.67,DB组为93.13±3.31(P值 = 0.202,无统计学意义)。根据客观IKDC评分,两组所有患者均为A级或B级。SB组平均胫骨前移差值为1.45±0.6 mm,DB组为1.17±0.8 mm(P值 = 0.105,无统计学意义)。DB组所有患者轴移试验均为阴性,而SB组有2例患者轴移试验为阳性。手术膝关节的MRI显示,两组间平均矢状面ACL移植物 - 胫骨角和平均冠状面ACL移植物 - 胫骨角的值具有可比性(P值>0.05,无统计学意义)。
在平均35个月的随访中,单束与双束ACL重建组在膝关节稳定性、膝关节评分、主观评估以及移植物倾斜角度的MRI评估方面均无统计学显著差异。