Jeon Yoon Sang, Choi Sung Wook, Park Ju Hyun, Yoon Jae Sik, Shin Jung Sub, Kim Myung Ku
Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
Department of Orthopedic Surgery, Jeju National University College of Medicine, Jeju, Korea.
Knee Surg Relat Res. 2017 Mar 1;29(1):19-25. doi: 10.5792/ksrr.15.061.
The purpose of this study was to evaluate the mid-term outcomes of anatomic anterior cruciate ligament (ACL) reconstruction using two anteromedial (AM) portals by comparing with short-term follow-up results.
Fifty patients who were treated by ACL reconstruction using a two AM portal technique were evaluated retrospectively. The follow-up period was at least 5 years. The mean follow-up period was 68.5±13.9 months. The mid-term clinical outcomes were compared with short-term (≥12 months) results. For the assessment of knee stability, anterior tibial translation was evaluated using the Lachman test and the KT-2000. Rotational stability was evaluated using pivot shift test. For clinical assessment, the Lysholm and International Knee Documentation Committee scores were used.
The average anterior translation was 2.1±1.4 mm at the short-term follow-up and 2.8±1.8 mm at the mid-term follow-up. Stability and mid-term clinical outcomes were not significantly improved compared to the short-term follow-up results. At the mid-term follow-up, anteroposterior (AP) instability assessed by the KT-2000 was slightly increased, but still acceptable. On the other clinical physical evaluation, there was no statistically significant difference.
The short-term and mid-term outcomes of ACL reconstruction using the two AM portal technique were not significantly different except for AP stability although the value was less than 3 mm at both follow-ups. Therefore, this operative technique could be considered a satisfactory alternative for ACL reconstruction.
本研究的目的是通过与短期随访结果进行比较，评估使用两个前内侧（AM）入路进行解剖学前交叉韧带（ACL）重建的中期结果。
回顾性评估50例采用双AM入路技术进行ACL重建的患者。随访期至少5年。平均随访期为68.5±13.9个月。将中期临床结果与短期（≥12个月）结果进行比较。为评估膝关节稳定性，采用Lachman试验和KT-2000评估胫骨前移。采用轴移试验评估旋转稳定性。为进行临床评估，使用Lysholm评分和国际膝关节文献委员会评分。
短期随访时平均前移为2.1±1.4mm，中期随访时为2.8±1.8mm。与短期随访结果相比，稳定性和中期临床结果没有显著改善。在中期随访时，通过KT-2000评估的前后（AP）不稳定略有增加，但仍可接受。在其他临床体格检查中，没有统计学上的显著差异。
采用双AM入路技术进行ACL重建的短期和中期结果除AP稳定性外无显著差异，尽管两次随访时该值均小于3mm。因此，这种手术技术可被认为是ACL重建的一种令人满意的替代方法。
