He Qingsong, Zhuang Leiting, An Zihao, Xu Wennan, Zhang Hangzhou
Department of Sports Medicine and Joint Surgery/Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang Liaoning, 110001, P.R.China.
Department of Sports Medicine and Joint Surgery/Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang Liaoning, 110001,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Feb 15;33(2):149-153. doi: 10.7507/1002-1892.201809132.
To investigate the feasibility and effectiveness of a novel remnant-preserving anterior cruciate ligament (ACL) reconstruction with bidirectional barbed suture.
Between February 2014 and January 2016, 96 patients (96 knees) with ACL injury who met the inclusion criteria were recruited and randomly divided into 2 groups ( =48). All patients underwent ACL reconstruction with autologous tendon. The tibial remnant was fixed with PDS-Ⅱ suture (control group) and bidirectional barbed suture (trial group). There was no significant difference in age, gender, injury side, the interval from injury to operation, and preoperative knee stability (KT-1000 test), International Knee Documentation Committee (IKDC) score, and Lysholm score ( >0.05). The knee stability (KT-1000 test), IKDC score, Lysholm score, proprioception, and Cyclops lesion after operation were recorded.
All incisions healed by first intention in both groups. Forty-four patients in control group were followed up 26-47 months (mean, 36.6 months), and 45 patients in trial group were followed up 26-48 months (mean, 35.6 months). At last follow-up, the IKDC score, Lysholm score, and KT-1000 test were significantly improved when compared with preoperative ones in both groups ( <0.05); but no significant difference was found between 2 groups ( >0.05). There was no significant difference in proprioception between 2 groups at 1 and 2 years after operation, and between 1 year after operation and 2 years after operation ( >0.05) in the same group. The incidences of Cyclops lesion at 6 months, 1 year and 2 years after operation were 0, 4.44% (2/45), and 4.44% (2/45) in trial group, and 13.6% (6/44), 13.6% (6/44), 20.5% (9/44) in control group, showing significant differences between 2 groups at 6 months and at 2 years after operation ( =0.012; =0.022) and no significant difference at 1 year after operation ( =0.157).
The remnant-preserving ACL reconstruction with bidirectional barbed suture can decrease the incidence of Cyclops lesions. However, this technique can not improve the effectiveness in terms of the clinical function and stability compared with the traditional technique.
探讨采用双向倒刺缝线进行新型保留残端前交叉韧带（ACL）重建的可行性和有效性。
2014年2月至2016年1月，招募96例符合纳入标准的ACL损伤患者（96膝），随机分为2组（每组48例）。所有患者均采用自体肌腱进行ACL重建。胫骨残端分别用PDS -Ⅱ缝线固定（对照组）和双向倒刺缝线固定（试验组）。两组患者在年龄、性别、损伤侧、受伤至手术间隔时间以及术前膝关节稳定性（KT - 1000测试）、国际膝关节文献委员会（IKDC）评分和Lysholm评分方面均无显著差异（P>0.05）。记录术后膝关节稳定性（KT - 1000测试）、IKDC评分、Lysholm评分、本体感觉及Cyclops病变情况。
两组切口均一期愈合。对照组44例患者随访26 - 47个月（平均36.6个月），试验组45例患者随访26 - 48个月（平均35.6个月）。末次随访时，两组IKDC评分、Lysholm评分及KT - 1000测试结果与术前相比均显著改善（P<0.05）；但两组间比较无显著差异（P>0.05）。术后1年和2年两组间本体感觉无显著差异，同组术后1年与术后2年比较也无显著差异（P>0.05）。试验组术后6个月、1年和2年Cyclops病变发生率分别为0、4.44%（2/45）和4.44%（2/45），对照组分别为13.6%（6/44）、13.6%（6/44）、20.5%（9/44），术后6个月和2年两组间差异有统计学意义（P = 0.012；P = 0.022），术后1年差异无统计学意义（P = 0.157）。
采用双向倒刺缝线进行保留残端的ACL重建可降低Cyclops病变的发生率。然而，与传统技术相比，该技术在临床功能和稳定性方面并未提高有效性。
