Chung Kyu Sung, Ha Jeong Ku, Ra Ho Jong, Kim Sang Bum, Lee Gu Hyun, Kim Jin Goo
Department of Orthopedic Surgery, Hanil General Hospital, Seoul, Korea.
Department of Orthopedic Surgery, Sports Medical Center, Sports Medical Research Institute, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea.
Arch Orthop Trauma Surg. 2017 Dec;137(12):1725-1733. doi: 10.1007/s00402-017-2808-6. Epub 2017 Oct 20.
To investigate the effect of synovialization of graft following anterior cruciate ligament reconstruction (ACLR) on functional performance test (FPT) and clinical outcomes.
Eighty-four male patients who underwent second-look arthroscopy at 2-year follow-up after unilateral ACLR using hamstring autograft were analyzed retrospectively. Patients were categorized by synovial coverage into A group (42 subjects, poor synovial coverage) and B group (42 subjects, good synovial coverage). FPT results, including those of single leg hop test (cm) of the involved limb, co-contraction test (s), shuttle run test (s), and carioca test (s), were compared between groups. Clinical scores, including Lysholm score, International Knee Documentation Committee (IKDC) subjective score, and Tegner activity score; stability assessments including Lachman test, Pivot-shift test, and side-to-side differences (cm) measured using a KT-2000 arthrometer were also compared between groups.
Based on FPT results, no difference was evident between groups. Single leg hop test results were 144.3 ± 25.5 in A group and 145.4 ± 24.7 in B group (P = 0.849). Co-contraction test results were 17.1 ± 2.9 in A group and 16.9 ± 3.6 in B group (P = 0.827). Shuttle run test results were 9.3 ± 1.9 in A group and 9.3 ± 1.9 in B group (P = 0.935). Carioca test results were 11.4 ± 2.9 in A group and 10.5 ± 2.5 in B group (P = 0.149). Clinical scores and stability assessments did not differ between groups (P > 0.05).
Based on functional performance results, well-synovialized grafts did not yield better functional performance outcomes following ACLR compared to poorly synovialized grafts at 2-year follow-up. The same was true of clinical outcomes. Thus, the success of synovialization does not improve functional performance and clinical outcomes following ACL reconstruction in an all-male population.
探讨前交叉韧带重建（ACLR）术后移植物滑膜化对功能性能测试（FPT）和临床结果的影响。
回顾性分析84例使用腘绳肌自体移植物进行单侧ACLR术后2年接受二次关节镜检查的男性患者。根据滑膜覆盖情况将患者分为A组（42例，滑膜覆盖差）和B组（42例，滑膜覆盖良好）。比较两组的FPT结果，包括患侧单腿跳测试（厘米）、共同收缩测试（秒）、往返跑测试（秒）和 carioca 测试（秒）。还比较两组的临床评分，包括 Lysholm 评分、国际膝关节文献委员会（IKDC）主观评分和 Tegner 活动评分；稳定性评估包括 Lachman 试验、轴移试验以及使用 KT - 2000 关节测量仪测量的两侧差异（厘米）。
基于FPT结果，两组之间无明显差异。A组单腿跳测试结果为144.3±25.5，B组为145.4±24.7（P = 0.849）。A组共同收缩测试结果为17.1±2.9，B组为16.9±3.6（P = 0.827）。A组往返跑测试结果为9.3±1.9，B组为9.3±1.9（P = 0.935）。A组carioca测试结果为11.4±2.9，B组为10.5±2.5（P = 0.149）。两组的临床评分和稳定性评估无差异（P>0.05）。
基于功能性能结果，在2年随访时，与滑膜化不良的移植物相比，滑膜化良好的移植物在ACLR后并未产生更好的功能性能结果。临床结果也是如此。因此，在全男性人群中，滑膜化的成功与否并不会改善ACL重建后的功能性能和临床结果。
