Chia Zi-Yang, Chee Jade N, Bin-Abd-Razak Hamid Rahmatullah, Lie Denny Tt, Chang Paul Cc
1 Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
2 Singhealth, Singapore.
J Orthop Surg (Hong Kong). 2018 May-Aug;26(2):2309499018773124. doi: 10.1177/2309499018773124.
PURPOSE: Reconstruction of the anterior cruciate ligament (ACL) is the most frequently performed reconstructive surgery in the knee. Biomechanical studies have shown that double bundle (DB) reconstruction is better than single bundle (SB) reconstruction with regard to rotational stability. It is postulated that resection of ACL fibres that remain in continuity may be counterproductive for the knee as these fibres have the capacity to produce collagen. In this study, we aimed to evaluate the efficacy among selective bundle, DB and SB ACL reconstructions over a 2-year post-operative follow-up period. METHODS: A retrospective comparative study was conducted for comparison between selective bundle, DB and SB reconstructions. Between 2012 and 2014, 291 ACL reconstructions were performed. Of these, 68 patients had selective ACL reconstructions (group SLB), 147 had DB ACL reconstructions (group DB) and 76 had SB ACL reconstructions (group SB). Institutional Review Board approval was obtained, and all patients provided informed consent. Clinical results were assessed with the International Knee Documentation Committee (IKDC), Lysholm and Tegner scores. Stability was measured using Lachman, pivot shift and anterior drawer stress tests using the KT1000 at 30° of knee flexion. RESULTS: There was no significant difference in ligament grade, function grade, IKDC grade, as well as Tegner and Lysholm means among all three groups after a 2-year follow-up period. CONCLUSION: Selective bundle reconstruction provides comparable results to DB and SB reconstruction techniques. It is a viable alternative for patients with partial tears.
目的:前交叉韧带(ACL)重建是膝关节最常进行的重建手术。生物力学研究表明,在旋转稳定性方面,双束(DB)重建优于单束(SB)重建。据推测,保留连续的ACL纤维进行切除可能对膝关节产生适得其反的效果,因为这些纤维有产生胶原蛋白的能力。在本研究中,我们旨在评估选择性束、DB和SB ACL重建在术后2年随访期内的疗效。 方法:进行一项回顾性比较研究,比较选择性束、DB和SB重建。2012年至2014年期间,共进行了291例ACL重建。其中,68例患者进行了选择性ACL重建(SLB组),147例进行了DB ACL重建(DB组),76例进行了SB ACL重建(SB组)。获得了机构审查委员会的批准,所有患者均提供了知情同意书。临床结果采用国际膝关节文献委员会(IKDC)、Lysholm和Tegner评分进行评估。在膝关节屈曲30°时,使用KT1000通过Lachman、轴移和前抽屉应力试验测量稳定性。 结果:2年随访期后,三组在韧带分级、功能分级、IKDC分级以及Tegner和Lysholm平均值方面均无显著差异。 结论:选择性束重建与DB和SB重建技术的效果相当。对于部分撕裂的患者,它是一种可行的替代方案。
J Orthop Surg (Hong Kong). 2018
Knee Surg Sports Traumatol Arthrosc. 2011-2-11
Knee Surg Sports Traumatol Arthrosc. 2017-11-20
Am J Sports Med. 2013-8-19
Acta Chir Orthop Traumatol Cech. 2014
Arthrosc Tech. 2019-12-23