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同种异体半腱肌腱重建慢性跟腱断裂的中期良好结果。

Good outcomes at mid-term following the reconstruction of chronic Achilles tendon rupture with semitendinosus allograft.

机构信息

Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.

Department of Orthopedics, The Second Affiliated Hospital of Jiaxing University, Zhejiang, 314000, China.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 May;28(5):1619-1624. doi: 10.1007/s00167-018-5113-1. Epub 2018 Aug 20.

Abstract

PURPOSE

Chronic Achilles tendon rupture is commonly treated surgically, yet there are limited available data on tendon allografts for Achilles tendon reconstruction. The purpose of this study was to evaluate the patient-reported outcomes of chronic Achilles tendon rupture reconstructed with semitendinosus allograft.

METHODS

A total of 34 patients (30 males and 4 females, average age 36.1 ± 6.8 years ranging from 25 to 50 years) who underwent Achilles tendon reconstruction with semitendinosus allograft from 2011 to 2015 were identified for this retrospective study. The American Orthopedic Foot and Ankle Society (AOFAS) score, Victorian Institute of Sports Assessment-Achilles (VISA-A) score, Achilles tendon total rupture score (ATRS), and Tegner score were evaluated preoperatively and at final follow-up.

RESULTS

A total of 33 patients (97.1%) were followed up for a median time of 53 (range 24-80) months. The median AOFAS score increased from 50 (5-75) to 100 (86-100), the median VISA-A score increased from 23 (5-59) to 94 (52-100), the median ATRS score increased from 22.5 (6-67) to 99 (84-100), and the median Tegner score increased from 1 (0-3) to 4 (3-9).

CONCLUSIONS

Reconstruction of chronic-ruptured Achilles tendon with semitendinosus allograft offers satisfactory patient-reported results with low risk of re-rupture and complications. This technique could be considered an effective alternative for chronic ruptures of the Achilles tendon.

LEVEL OF EVIDENCE

Case series, Level IV.

摘要

目的

慢性跟腱断裂通常采用手术治疗,但跟腱重建中同种异体肌腱的应用数据有限。本研究旨在评估半腱肌同种异体移植物重建慢性跟腱断裂的患者报告结果。

方法

本回顾性研究共纳入 2011 年至 2015 年间采用半腱肌同种异体移植物重建跟腱的 34 例患者(30 名男性和 4 名女性,平均年龄 36.1±6.8 岁,年龄范围为 25 岁至 50 岁)。术前和末次随访时评估美国矫形足踝协会(AOFAS)评分、维多利亚运动评估-跟腱(VISA-A)评分、跟腱总断裂评分(ATRS)和 Tegner 评分。

结果

共 33 例患者(97.1%)获得随访,随访中位数时间为 53 个月(范围 24-80 个月)。AOFAS 评分中位数从 50 分(范围 5-75 分)增加至 100 分(范围 86-100 分),VISA-A 评分中位数从 23 分(范围 5-59 分)增加至 94 分(范围 52-100 分),ATRS 评分中位数从 22.5 分(范围 6-67 分)增加至 99 分(范围 84-100 分),Tegner 评分中位数从 1 分(范围 0-3 分)增加至 4 分(范围 3-9 分)。

结论

半腱肌同种异体移植物重建慢性跟腱断裂可获得满意的患者报告结果,且再断裂和并发症风险低。该技术可被视为慢性跟腱断裂的有效替代方法。

证据等级

病例系列,IV 级。

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