Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany.
Movement Analysis Lab, Institute for Experimental Musculoskeletal Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building D3, 48149, Münster, Germany.
Knee Surg Sports Traumatol Arthrosc. 2018 Feb;26(2):374-380. doi: 10.1007/s00167-017-4618-3. Epub 2017 Jul 3.
Dynamic intraligamentary stabilization (DIS) has been introduced as a new technique to repair the torn anterior cruciate ligament (ACL) and to restore knee joint kinematics after an acute ACL tear. Aim of the present study was to compare the early post-operative activity, restoration of gait pattern and functional results after DIS in comparison with primary ACL reconstruction (ACLR) for acute ACL tears. It was hypothesized that functional results, post-operative activity and changes in gait pattern after DIS are comparable to those after ACLR.
Sixty patients with acute ACL tears were included in this study and underwent either DIS or ACLR with an anatomic semitendinosus autograft in a randomized manner. Patients were equipped with an accelerometric step counter for the first 6 weeks after surgery in order to monitor their early post-operative activity. 3D gait analysis was performed at 6 weeks and 6 months after surgery. Temporal-spatial, kinematic and kinetic parameters were extracted and averaged for each subject. Functional results were recorded at 6 weeks, 6 months and 12 months after surgery using the Tegner activity scale, International Knee Documentation Committee score and Lysholm score.
Patients who underwent DIS showed an increased early post-operative activity with significant differences at week 2 and 3 (p = 0.0241 and 0.0220). No significant differences between groups were found for knee kinematic and kinetic parameters or the functional scores at any time of the follow-up. Furthermore, the difference in anterior tibial translation was not significantly different between the two groups (n.s.).
Early functional results and changes in gait pattern after DIS are comparable to those of primary ACLR. Therefore, ACL repair may be an alternative to ACLR in this cohort of patients.
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动态关节内稳定（DIS）已被引入作为一种修复撕裂前交叉韧带（ACL）并恢复急性 ACL 撕裂后膝关节运动学的新技术。本研究的目的是比较 DIS 与 ACL 重建（ACLR）治疗急性 ACL 撕裂后的早期术后活动、步态模式恢复和功能结果。假设 DIS 后的功能结果、术后活动和步态模式变化与 ACLR 后相似。
本研究纳入了 60 例急性 ACL 撕裂患者，随机接受 DIS 或 ACLR 治疗，使用解剖半腱肌自体移植物。患者在手术后的前 6 周内配备了加速度计计步器，以监测他们的早期术后活动。在手术后 6 周和 6 个月进行 3D 步态分析。提取并平均每个受试者的时空、运动学和动力学参数。在手术后 6 周、6 个月和 12 个月记录功能结果，使用 Tegner 活动量表、国际膝关节文献委员会评分和 Lysholm 评分。
接受 DIS 的患者术后早期活动增加，第 2 周和第 3 周差异有统计学意义（p=0.0241 和 0.0220）。在随访的任何时间，两组之间在膝关节运动学和动力学参数或功能评分方面均无显著差异。此外，两组之间的胫骨前移位差异无统计学意义（n.s.）。
DIS 后的早期功能结果和步态模式变化与 ACLR 相似。因此，在这组患者中，ACL 修复可能是 ACLR 的替代方法。
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