Asmussen Christian Asmus Peter, Attrup Mikkel Lindegaard, Thorborg Kristian, Hölmich Per
Sports Orthopedic Research Centre-Copenhagen, Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark.
Orthop J Sports Med. 2018 Jun 14;6(6):2325967118778507. doi: 10.1177/2325967118778507. eCollection 2018 Jun.
Biomechanical studies show varying results regarding the elongation of adjustable fixation devices. This has led to growing concern over the stability of the ToggleLoc with ZipLoop used in anterior cruciate ligament (ACL) reconstruction (ACLR) in vivo.
PURPOSE/HYPOTHESIS: The purpose of this study was to compare passive knee stability 1 year after ACLR in patients in whom the Endobutton or ToggleLoc with ZipLoop was used for femoral graft fixation. The hypothesis was that the ToggleLoc with ZipLoop would be inferior in knee stability to the Endobutton 1 year after primary ACLR.
Cohort study; Level of evidence, 2.
Data from 3175 patients (Endobutton: n = 2807; ToggleLoc with ZipLoop: n = 368) were included from the Danish Knee Ligament Reconstruction Registry (DKRR) between June 2010 and September 2013. Data were retrieved from standardized ACL forms filled out by the operating surgeon preoperatively, during surgery, and at a clinical examination 1 year after surgery. Passive knee stability was evaluated using 1 of 2 arthrometers (Rolimeter or KT-1000 arthrometer) and the pivot-shift test. Using the same database, the number of reoperations performed up to 4 years after primary surgery was examined.
Full data were available for 1654 patients (Endobutton: n = 1538; ToggleLoc with ZipLoop: n = 116). ACLR with both devices resulted in increased passive knee stability ( < .001). Patients who received the ToggleLoc with ZipLoop were found to have a better preoperative ( = .005 ) and postoperative ( < .001) pivot-shift test result. No statistically significant difference regarding the number of reoperations ( .086) or the time to reoperation ( .295) was found.
Patients who underwent fixation with the ToggleLoc with ZipLoop had improved passive knee stability 1 year after surgery, measured by anterior tibial translation and pivot-shift test results, similar to patients who underwent fixation with the Endobutton. No difference was seen in knee stability or reoperation rates between the 2 devices.
生物力学研究显示，关于可调节固定装置的延长情况，结果各不相同。这使得人们越来越担心在体内前交叉韧带重建（ACLR）中使用带ZipLoop的ToggleLoc的稳定性。
目的/假设：本研究的目的是比较在使用Endobutton或带ZipLoop的ToggleLoc进行股骨移植物固定的患者中，ACLR术后1年时的被动膝关节稳定性。假设是在初次ACLR术后1年，带ZipLoop的ToggleLoc在膝关节稳定性方面不如Endobutton。
队列研究；证据等级，2级。
纳入丹麦膝关节韧带重建登记处（DKRR）在2010年6月至2013年9月期间的3175例患者的数据（Endobutton组：n = 2807；带ZipLoop的ToggleLoc组：n = 368）。数据取自手术医生在术前、术中以及术后1年临床检查时填写的标准化ACLR表格。使用两种关节测量仪（旋转测量仪或KT - 1000关节测量仪）中的一种以及轴移试验来评估被动膝关节稳定性。利用同一数据库，检查初次手术后长达4年的再次手术次数。
1654例患者有完整数据（Endobutton组：n = 1538；带ZipLoop的ToggleLoc组：n = 116）。两种装置进行的ACLR均导致被动膝关节稳定性增加（P <.001）。发现接受带ZipLoop的ToggleLoc的患者术前（P = .005）和术后（P <.001）轴移试验结果更好。在再次手术次数（P = .086）或再次手术时间（P = .295）方面未发现统计学上的显著差异。
通过前胫骨平移和轴移试验结果测量，接受带ZipLoop的ToggleLoc固定的患者在术后1年时被动膝关节稳定性有所改善，与接受Endobutton固定的患者相似。两种装置在膝关节稳定性或再次手术率方面没有差异。
