Başdelioğlu Koray, Meriç Gökhan, Pündük Zekine, Akseki Devrim, Atik Aziz, Sargın Serdar
Istanbul Oncology Hospital, Department of Orthopaedic and Traumatology, Istanbul, Turkey.
Yeditepe University, Medical Faculty, Department of Orthopaedic and Traumatology, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2019 Mar;53(2):86-91. doi: 10.1016/j.aott.2019.01.004. Epub 2019 Feb 8.
The aim of the study was to compare the outcomes of the transtibial and anatomical femoral single tunnel surgical techniques in ACL reconstruction.
A total of 30 patients, with 16 patients (15 males and 1 female; mean age: 27.2 ± 7.04) with anatomical femoral single-tunnel technique (AFT) and 14 (12 males and 2 females; mean age: 29.4 ± 8.82) with transtibial technique (TT) were included into the study. All patients were evaluated with isokinetic tests at an angular velocity of 60°/s and 180°/s and the IKDC and Lysholm tests were performed preoperatively and in third, sixth, and 12th months postoperatively. The results were compared between the groups. The mean follow-up time was 17.1 ± 6.48 months.
Postoperative third month changes in extension parameters of peak torque (AFT: -93.286, TT: -61.500), peak work (AFT: -77.071, TT: -47.500), peak torque ext/kg (AFT: -1.182, TT: -0.773), peak work ext/kg (AFT: -0.982, TT: -0.604), peak work (AFT: -55.143 TT: -33.063) at an angular velocity of 60°/s and postoperative third month change in extension parameter of peak power (AFT: -86.786 TT: -54.875) at an angular velocity of 180°/s were found to be better in the transtibial group (p < 0.05) and postoperative sixth month peak torque (AFT: 1.429, TT: -5.688) value at an angular velocity of 60°/s was found to be less in the anatomical femoral single-tunnel group (p < 0.05). The IKDC (AFT: 94.671, TT: 90.025) (p < 0.05) and Lysholm (AFT: 96.714, TT: 92.375) (p < 0.05) scores of the anatomical femoral single-tunnel group were better than the transtibial group regarding to the postoperative final follow-up. There are positive intermediate correlations between preoperative IKDC and Lysholm scores with preoperative and postoperative some isokinetic test ratio (r = 0.539; p = 0.031), and preoperative peak power extension (r = 0.541; p = 0.030) at the both angular velocity of 60°/s and 180°/s in the transtibial group. There was no significant difference between the two groups with regards to the Lachman, anterior drawer and pivot shift tests (p < 0.05).
There were differences in terms of isokinetic parameters in early outcomes but there was no statistical difference between isokinetic parameters at the end of 1st year between two groups. There were some correlations between IKDC and Lysholm scores with some isokinetic parameters.
Level III, Therapeutic Study.
本研究旨在比较经胫骨和解剖学股骨单隧道手术技术在 ACL 重建中的效果。
共纳入 30 例患者，其中 16 例（15 例男性和 1 例女性；平均年龄：27.2 ± 7.04）采用解剖学股骨单隧道技术（AFT），14 例（12 例男性和 2 例女性；平均年龄：29.4 ± 8.82）采用经胫骨技术（TT）。所有患者均在角速度为 60°/s 和 180°/s 时进行等速测试，并在术前以及术后第 3、6 和 12 个月进行 IKDC 和 Lysholm 测试。对两组结果进行比较。平均随访时间为 17.1 ± 6.48 个月。
在角速度为 60°/s 时，术后第 3 个月经胫骨组在伸展参数方面的峰值扭矩（AFT：-93.286，TT：-61.500）、峰值功（AFT：-77.071，TT：-47.500）、峰值扭矩 ext/kg（AFT：-1.182，TT：-0.773）、峰值功 ext/kg（AFT：-0.982，TT：-0.604）、峰值功（AFT：-55.143，TT：-33.063）的变化以及在角速度为 180°/s 时术后第 3 个月峰值功率伸展参数的变化（AFT：-86.786，TT：-54.875）均优于解剖学股骨单隧道组（p < 0.05）；在角速度为 60°/s 时，解剖学股骨单隧道组术后第 6 个月的峰值扭矩（AFT：1.429，TT：-5.688）值低于经胫骨组（p < 0.05）。在术后最终随访时，解剖学股骨单隧道组的 IKDC（AFT：94.671，TT：90.025）（p < 0.05）和 Lysholm（AFT：96.714，TT：92.375）（p < 0.05）评分优于经胫骨组。在经胫骨组中，术前 IKDC 和 Lysholm 评分与术前及术后一些等速测试比值之间存在正中度相关性（r = 0.539；p = 0.031），以及在角速度为 60°/s 和 180°/s 时术前峰值功率伸展之间存在正中度相关性（r = 0.541；p = 0.030）。两组在 Lachman、前抽屉和轴移试验方面无显著差异（p < 0.05）。
早期结果在等速参数方面存在差异，但两组在第 1 年末的等速参数之间无统计学差异。IKDC 和 Lysholm 评分与一些等速参数之间存在一些相关性。
III 级，治疗性研究。
