Sports Injury Centre, Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
Baba Farid University of Health Sciences, Faridkot, India.
Arthroscopy. 2017 Dec;33(12):2208-2216. doi: 10.1016/j.arthro.2017.06.040. Epub 2017 Sep 29.
To compare mechanical stability, functional outcome, and level of return to sports activity in patients undergoing anterior cruciate ligament (ACL) reconstruction with a free hamstring graft versus a graft with preserved insertions at 2-year follow-up.
This study was a prospective, single-blind (the evaluator was blinded), randomized trial of 110 adult professional athletes who were randomly allocated into 2 groups. Group 1 consisted of 55 patients who underwent ACL reconstruction with hamstring tendon autograft with preserved insertions (technique 1), and group 2 consisted of 55 patients who underwent ACL reconstruction with free hamstring tendon autograft (technique 2). An anteromedial portal was used for drilling of the femoral tunnel in all cases. Patients were assessed for a minimum follow-up of 2 years with clinical tests, the Activities of Daily Living Function Scale and Sports Function Scale (Cincinnati knee score), knee arthrometer (KT-1000) testing, and the Tegner activity scale.
The average age of the patients was 27.0 ± 7.5 years in group 1 and 27.2 ± 5.7 years in group 2. At 24 months, the mean side-to-side difference by KT-1000 testing was 1.4 in group 1 and 2.2 in group 2 (P < .0001); the mean Cincinnati knee score (Activities of Daily Living Function Scale and Sports Function Scale) was 418.5 (median, 420; range, 400-420) and 406.8 (median, 420; range, 350-420), respectively (P < .0001); and the mean difference between the preinjury and postsurgery Tegner level of sports activity was 0.3 and 1.08, respectively (P = .027).
Although ACL reconstruction using hamstring autograft with preserved insertions resulted in statistically superior anterior stability, a better functional outcome, and a closer return to the preinjury level of sports activity as compared with free autograft, no clinically significant difference was proved.
Level I, randomized controlled trial.
比较前交叉韧带（ACL）重建中使用游离腘绳肌腱移植物与保留止点的移植物的机械稳定性、功能结果和重返运动活动水平，随访时间为 2 年。
这是一项前瞻性、单盲（评估者设盲）、随机临床试验，纳入 110 名成年职业运动员，随机分为 2 组。组 1 55 例患者采用保留止点的腘绳肌腱自体移植物重建 ACL（技术 1），组 2 55 例患者采用游离腘绳肌腱自体移植物重建 ACL（技术 2）。所有病例均采用前内侧入路钻取股骨隧道。患者接受至少 2 年的随访，通过临床检查、日常生活活动功能量表和运动功能量表（辛辛那提膝关节评分）、膝关节关节计（KT-1000）测试和 Tegner 活动量表进行评估。
组 1 患者的平均年龄为 27.0 ± 7.5 岁，组 2 为 27.2 ± 5.7 岁。24 个月时，KT-1000 测试的平均侧间差值在组 1 为 1.4，在组 2 为 2.2（P <.0001）；平均辛辛那提膝关节评分（日常生活活动功能量表和运动功能量表）分别为 418.5（中位数，420；范围，400-420）和 406.8（中位数，420；范围，350-420）（P <.0001）；术前和术后 Tegner 运动活动水平的平均差值分别为 0.3 和 1.08（P =.027）。
尽管与游离自体移植物相比，使用保留止点的腘绳肌腱自体移植物重建 ACL 在统计学上具有更好的前向稳定性、更好的功能结果和更接近术前的运动活动水平，但没有证明存在临床显著差异。
Ⅰ级，随机对照试验。
