Gelenkpunkt, Sport- and Joint Surgery, Olympiastrasse 36, 6020, Innsbruck, Austria.
Medical University of Innsbruck, Innsbruck, Austria.
Knee Surg Sports Traumatol Arthrosc. 2018 Feb;26(2):605-614. doi: 10.1007/s00167-017-4554-2. Epub 2017 May 5.
Graft choice for anterior cruciate ligament (ACL) reconstruction is crucial, however the optimal graft source remains a topic of controversy. The purpose of this study is to compare subjective and functional patient-reported outcomes (PRO) after single-bundle ACL reconstruction using quadriceps tendon (QT) or hamstring tendon (HT) autografts for single-bundle ACL reconstruction. We hypothesize that there is no difference in patient-reported functional outcomes after ACL reconstruction using either HT- or QT autograft.
All data were extracted from a prospectively collected ACL registry. A total of 80 patients with at least 2-year follow-up were included in this study. A total of 40 patients with primary ACL reconstruction using a QT autograft harvested via a minimally invasive technique were matched by sex, age and pre-injury Tegner and Lysholm score to 40 patients who received HT autografts. Subjective and functional PRO scores including Lysholm score, Tegner activity level and visual analogue scale for pain were obtained at 6, 12 and 24 months after index surgery.
No significant difference between the QT and the HT group was seen at any follow-up in regard to any of the PRO scores for function or pain. 24 months post-surgery the mean Tegner activity score of the HT group was significantly (p = 0.04) lower compared to the pre-injury status. At final follow-up, 27 patients (67.5%) in the QT group and 32 patients (80.0%) in the HT returned to their pre-injury activity level (n.s.). A total of 37 patients (92.5%) of the QT cohort and 35 patients (87.5%) of the HT cohort reported "good" or "excellent" results according to the Lysholm score (n.s.). "No pain" or "slight pain" during severe exertion was reported by 33 patients (82.5%) with QT autograft and 28 patients (82.4%) with HT autograft (n.s.).
There is no significant difference between PRO 2 years post-operative using either QT or HT autografts. Both QT and HT grafts show acceptable and comparable PRO scores making the QT a reliable graft alternative to HT for primary ACL reconstruction.
III.
前交叉韧带（ACL）重建时移植物的选择至关重要，但最佳移植物来源仍存在争议。本研究旨在比较使用股四头肌肌腱（QT）或腘绳肌腱（HT）自体移植物进行单束 ACL 重建后，单束 ACL 重建的患者主观和功能报告的结果（PRO）。我们假设使用 HT 或 QT 自体移植物进行 ACL 重建后，患者报告的功能结果没有差异。
所有数据均从前瞻性收集的 ACL 注册处提取。本研究共纳入 80 例至少随访 2 年的患者。40 例采用微创技术取自体 QT 移植物的患者与 40 例接受 HT 自体移植物的患者相匹配，匹配因素包括性别、年龄和术前 Tegner 和 Lysholm 评分。在索引手术后 6、12 和 24 个月时，获得 Lysholm 评分、Tegner 活动水平和疼痛视觉模拟评分等主观和功能 PRO 评分。
在任何随访中，QT 组和 HT 组在任何功能或疼痛的 PRO 评分方面均无显著差异。术后 24 个月，HT 组的 Tegner 活动评分明显（p=0.04）低于术前。在最终随访时，QT 组 27 例（67.5%）和 HT 组 32 例（80.0%）患者恢复到术前活动水平（无统计学意义）。QT 队列的 37 例（92.5%）和 HT 队列的 35 例（87.5%）患者根据 Lysholm 评分报告“良好”或“优秀”结果（无统计学意义）。33 例（82.5%）QT 自体移植物和 28 例（82.4%）HT 自体移植物患者在剧烈运动时报告“无疼痛”或“轻微疼痛”（无统计学意义）。
术后 2 年，使用 QT 或 HT 自体移植物的 PRO 无显著差异。QT 和 HT 移植物均显示出可接受和可比的 PRO 评分，使 QT 成为 HT 用于原发性 ACL 重建的可靠替代物。
III 级。
