Vaillant Eric R, Parks Brent G, Camire Lyn M, Hinton Richard Y
Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland.
J Knee Surg. 2017 Nov;30(9):916-919. doi: 10.1055/s-0037-1599248. Epub 2017 Mar 10.
The aim of this article is to compare diameter and stiffness, displacement, and strain in a five-strand versus four-strand hamstring graft for anterior cruciate ligament reconstruction. Eight matched pairs of lower extremities underwent four-strand or five-strand hamstring graft reconstruction. Diameter was significantly higher in the five-strand versus the four-strand construct ( = 0.002). No significant difference was found between the groups in construct displacement or stiffness. Significantly higher strain was observed in the inner limb versus the outer limb in the four-strand construct ( = 0.001) and in the inner limb versus the fifth limb in the 5-strand construct ( = 0.004). A fifth limb added to a four-strand hamstring graft significantly increased graft diameter but did not significantly change stiffness or displacement, suggesting that attachment of additional graft material via suture did not provide for full incorporation of the added limb into the graft at time zero. The inner limb in both constructs absorbed significantly greater load than did other limbs. The use of suture to attach additional material to a four-strand hamstring graft may not contribute to improved biomechanical qualities of the graft at time zero.
本文旨在比较用于前交叉韧带重建的五股与四股绳肌移植物的直径、刚度、位移和应变。八对匹配的下肢接受了四股或五股绳肌移植物重建。五股结构的直径显著高于四股结构（=0.002）。两组在结构位移或刚度方面未发现显著差异。在四股结构中，内肢相对于外肢的应变显著更高（=0.001），在五股结构中，内肢相对于第五肢的应变显著更高（=0.004）。在四股绳肌移植物上增加第五股显著增加了移植物直径，但未显著改变刚度或位移，这表明在零时通过缝合附加移植物材料并未使附加股完全融入移植物。两种结构中的内肢比其他肢体吸收的负荷显著更大。使用缝合将额外材料附着于四股绳肌移植物可能不会在零时改善移植物的生物力学性能。
