Buescu Cristian Tudor, Onutu Adela Hilda, Lucaciu Dan Osvald, Todor Adrian
Iuliu Hatieganu University of Medicine and Pharmacy, Department of Orthopedics, Traumatology and Pediatric Orthopedics, Cluj Napoca, Cluj, Romania.
Cluj Emercency County Clinical Hospital, Anesthesiology Department of Orthopedics Clinic, Cluj Napoca, Romania.
Acta Orthop Traumatol Turc. 2017 Mar;51(2):100-103. doi: 10.1016/j.aott.2017.02.011. Epub 2017 Feb 27.
The objective of this study was to compare the pain levels and analgesic consumption after single bundle ACL reconstruction with free quadriceps tendon autograft versus hamstring tendon autograft.
A total of 48 patients scheduled for anatomic single-bundle ACL reconstruction were randomized into two groups: the free quadriceps tendon autograft group (24 patients) and the hamstring tendons autograft group (24 patients). A basic multimodal analgesic postoperative program was used for all patients and rescue analgesia was provided with tramadol, at pain scores over 30 on the Visual Analog Scale. The time to the first rescue analgesic, the number of doses of tramadol and pain scores were recorded. The results within the same group were compared with the Wilcoxon signed test.
Supplementary analgesic drug administration proved significantly higher in the group of subjects with hamstring grafts, with a median (interquartile range) of 1 (1.3) dose, compared to the group of subjects treated with a quadriceps graft, median = 0.5 (0.1.25) (p = 0.009). A significantly higher number of subjects with a quadriceps graft did not require any supplementary analgesic drug (50%) as compared with subjects with hamstring graft (13%; Z-statistics = 3.01, p = 0.002). The percentage of subjects who required a supplementary analgesic drug was 38% higher in the HT group compared with the FQT group.
The use of the free quadriceps tendon autograft for ACL reconstruction leads to less pain and analgesic consumption in the immediate postoperative period compared with the use of hamstrings autograft.
Level I Therapeutic study.
本研究旨在比较采用游离股四头肌肌腱自体移植与腘绳肌肌腱自体移植进行单束前交叉韧带重建术后的疼痛程度和镇痛药物用量。
共有48例计划进行解剖单束前交叉韧带重建的患者被随机分为两组：游离股四头肌肌腱自体移植组（24例患者）和腘绳肌肌腱自体移植组（24例患者）。所有患者均采用基本的多模式术后镇痛方案，当视觉模拟评分疼痛评分超过30分时，使用曲马多进行解救镇痛。记录首次使用解救镇痛药物的时间、曲马多的用药剂量和疼痛评分。同组内的结果采用Wilcoxon符号秩检验进行比较。
与股四头肌移植组相比，腘绳肌移植组补充镇痛药物的使用量明显更高，中位数（四分位间距）为1（1.3）剂，而股四头肌移植组中位数为0.5（0.1，2.5）（p = 0.009）。与腘绳肌移植组患者（13%）相比，股四头肌移植组中无需任何补充镇痛药物的患者比例明显更高（50%）；Z统计量 = 3.01，p = 0.002。与股四头肌肌腱移植组相比，腘绳肌肌腱移植组中需要补充镇痛药物的患者百分比高38%。
与使用腘绳肌自体移植相比，采用游离股四头肌肌腱自体移植进行前交叉韧带重建在术后即刻可减轻疼痛并减少镇痛药物用量。
I级治疗性研究。
