Monaco Edoardo, Redler Andrea, Fabbri Mattia, Proietti Lorenzo, Gaj Edoardo, Daggett Matthew, Ferretti Andrea
a University of Rome la Sapienza, Sant'Andrea Hospital, Kirk Kilgour Sports Injury Center , Rome , Italy.
b Kansas City University of Medicine and Biosciences , Kansas City , MO , USA.
Phys Sportsmed. 2019 Feb;47(1):132-135. doi: 10.1080/00913847.2018.1537535. Epub 2018 Nov 2.
Recently, a new minimally invasive single bundle technique for anatomic ACL reconstruction has been described, called the 'All-Inside graft-link technique'. One of the advantages of this procedure is the reduced morbidity at the donor site as the graft choice is the quadrupled semitendinosus, thus sparing the gracilis tendon. The aim of this study was to evaluate isokinetic flexion strength recovery in patients who underwent a gracilis sparing technique compared to those with a full-tibial tunnel technique using a doubled gracilis and semitendinosus tendons (DGST) graft.
Patients were divided into two groups: Group A (22 patients) who underwent ACL reconstruction performed with an All-Inside graft-link technique; Group B (22 patients) who underwent ACL reconstruction with an Out-In technique and DGST graft. At a mean follow-up of 13 months, quadriceps and hamstring isokinetic peak torque deficits were recorded.
In group A, the mean side to side peak torque flexion difference between the operated and non-operated limbs was -3% and the mean torque at 30° was -7.5% at high angular velocity (180°/sec); the mean peak flexion torque was 7.2% and the mean torque at 30° was 3.1% at low angular velocity (60°/sec). In group B, the mean side to side peak flexion torque was -3.5% and the mean torque at 30° was -7.6% at high angular velocity (180°/sec); the mean peak flexion torque was -7.2% and the mean torque at 30° was -11% at low angular velocity (60°/sec). A statistically significant difference was found between the two groups at lower angular velocity both for the mean peak flexion torque and the mean torque at 30° (p = 0.009), with better results in the study group.
DISCUSSION/CONCLUSION: Gracilis sparing technique is a minimally invasive technique for ACL reconstruction and yielded a significantly better flexion strength recovery at lower angular velocity compared to a full tibial tunnel technique with DGST for ACL reconstruction.
最近，一种用于解剖学前交叉韧带重建的新型微创单束技术被报道，称为“全内置移植物连接技术”。该手术的优点之一是供区发病率降低，因为移植物选择的是股薄肌腱四倍体，从而保留了股薄肌肌腱。本研究的目的是评估采用保留股薄肌技术的患者与采用双股薄肌和半腱肌肌腱（DGST）移植物的全胫骨隧道技术的患者相比，等速屈曲力量的恢复情况。
患者分为两组：A组（22例患者）采用全内置移植物连接技术进行前交叉韧带重建；B组（22例患者）采用内外技术和DGST移植物进行前交叉韧带重建。平均随访13个月，记录股四头肌和腘绳肌等速峰值扭矩缺损。
A组中，手术侧与非手术侧肢体之间的平均峰值扭矩屈曲差异在高角速度（180°/秒）时为-3%，在30°时的平均扭矩为-7.5%；在低角速度（60°/秒）时，平均峰值屈曲扭矩为7.2%，在30°时的平均扭矩为3.1%。B组中，在高角速度（180°/秒）时，平均峰值屈曲扭矩的左右差异为-3.5%，在30°时的平均扭矩为-7.6%；在低角速度（60°/秒）时，平均峰值屈曲扭矩为-7.2%，在30°时的平均扭矩为-11%。两组在较低角速度下的平均峰值屈曲扭矩和30°时的平均扭矩均存在统计学显著差异（p = 0.009），研究组结果更好。
讨论/结论：保留股薄肌技术是一种用于前交叉韧带重建的微创技术，与采用DGST的全胫骨隧道技术进行前交叉韧带重建相比，在较低角速度下产生了明显更好的屈曲力量恢复。
