Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.
Speciality Registrar (T&O), Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, Scotland.
Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):60-67. doi: 10.1007/s00167-018-5239-1. Epub 2018 Oct 31.
The treatment of acute anterior cruciate ligament (ACL) ruptures with a repair technique has recently regained interest. A novel ACL repair technique was described using Independent Suture Tape Reinforcement with 2-year follow-up results.
Forty-two consecutive patients with an acute ACL rupture undergoing repair using this technique were followed up for a minimum of 2 years. Patients with mid-substance, distal ACL ruptures, poor ACL tissue quality or retracted ACL remnants as well as patients with multi-ligament injuries were excluded. Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analogue Pain Scale (VAS-pain), Veterans RAND 12 Item Health Survey (VR-12) and the Marx Activity scale were collected by online questionnaires. Two-year postoperative patients were asked by telephone if they had experienced a rerupture.
All the KOOS subscales improved significantly in comparison to the preoperative score. The largest improvement of all scores was seen at 3 months postoperatively which is significant in all cases. The KOOS sport and recreation showed a meaningful change and the largest improvement of the KOOS subscales at 3 months postoperatively, as well as the highest total improvement at 1 year postoperatively compared to preoperatively. The VAS-pain and VR-12 physical score improved significantly, however the Marx activity scale decreased significantly in comparison to preoperative scores. Two patients reported a rerupture (4.8%, CI 1.7-11.2%).
This is the first case series that described the 2-year follow-up results of patients with an acute, proximal ACL rupture, treated with the Independent Suture Tape Reinforcement repair technique. A meaningful KOOS sport and recreation change and significant improvements in the KOOS, VAS-pain and VR-12 physical scores as well as a significant decrease of the Marx activity scale in comparison to preoperative scores are demonstrated. Two of the 42 patients (4.8%) reported an ACL rerupture. Repair with this technique could be clinically relevant as a treatment option for patients with an acute, proximal ACL rupture which is not retracted and of good tissue quality.
IV.
最近,采用修复技术治疗急性前交叉韧带(ACL)断裂重新引起了人们的兴趣。一种新的 ACL 修复技术使用独立缝线带加固进行了描述,并获得了 2 年的随访结果。
对 42 例连续的急性 ACL 断裂患者采用该技术进行修复,并进行了至少 2 年的随访。排除中体部、ACL 远端断裂、ACL 组织质量差或回缩的 ACL 残端以及多韧带损伤的患者。通过在线问卷收集膝关节损伤和骨关节炎结果评分(KOOS)、视觉模拟疼痛量表(VAS-pain)、退伍军人 RAND 12 项健康调查(VR-12)和 Marx 活动量表。通过电话询问术后 2 年的患者是否经历过再断裂。
与术前评分相比,所有 KOOS 亚量表均显著改善。所有评分中,术后 3 个月的改善最大,且所有情况下均具有统计学意义。KOOS 运动和娱乐部分的变化具有意义,且术后 3 个月时 KOOS 亚量表的改善最大,以及术后 1 年时与术前相比总改善程度最高。VAS-pain 和 VR-12 身体评分显著改善,而 Marx 活动量表与术前评分相比显著降低。2 例患者(4.8%,CI 1.7-11.2%)报告 ACL 再断裂。
这是首例描述采用独立缝线带加固修复技术治疗急性、近端 ACL 断裂患者 2 年随访结果的病例系列研究。术后 2 年时,患者的 KOOS 运动和娱乐部分有意义的变化,KOOS、VAS-pain 和 VR-12 身体评分显著改善,而 Marx 活动量表与术前评分相比显著降低。42 例患者中有 2 例(4.8%)报告 ACL 再断裂。对于无回缩且组织质量良好的急性、近端 ACL 断裂患者,该技术修复可能是一种有临床意义的治疗选择。
IV 级。