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对带锁钉(TLS)前交叉韧带重建技术与腘绳肌肌腱移植技术进行独立临床评估,随访时间至少为12个月。

Independent clinical appraisal of the Tape Locking Screw (TLS) anterior cruciate ligament reconstruction technique compared with the hamstring graft technique with a minimum of 12-month follow-up.

作者信息

Orfeuvre B, Pailhé R, Sharma A, Gaillot J, Rubens Duval B, Saragaglia D

机构信息

Orthopaedic Surgery and Sports Traumatology Department, Hôpital Sud, Grenoble Alpes University Hospital, 38130, Échirolles, France.

The Royal Orthopaedic Hospital, Birmingham, UK.

出版信息

Eur J Orthop Surg Traumatol. 2019 Aug;29(6):1271-1276. doi: 10.1007/s00590-019-02418-2. Epub 2019 Mar 22.

Abstract

INTRODUCTION

The aim of this study was to assess the differential laxity after reconstruction of the anterior cruciate ligament (ACL) by the TLS technique using a single tendon, the semitendinosus in four-strand graft, compared with the hamstring technique which uses both the gracilis and semitendinosus. We hypothesised that this surgical technique would provide post-surgical differential laxity measurements at least as good as those of the hamstring technique.

MATERIALS AND METHODS

We carried out a prospective monocentric study on patients undergoing unilateral anterior cruciate ligament repair between December 2014 and June 2016. All patients were followed up for at least 12 months. The series compares 61 patients operated on using the TLS technique by the same surgeon, with 33 patients operated on using the hamstring technique by a second surgeon. The main objective of the study was to compare the post-operative differential laxity, measured using the KT1000, between the two techniques.

RESULTS

There was no significant difference in the patients' epidemiological characteristics and pre-operative scores between the two groups. Average pre-operative differential laxity was 6.5 mm ± 2.1 (min 3; max 12) in the TLS group and 6.4 mm ± 2.0 (min 0; max 11) in the hamstring group, with no statistically significant difference. The average post-operative difference in laxity was - 0.1 mm ± 1.9 (min - 5; max 4) in the TLS group and 0.3 mm ± 2.0 (min - 7; max 5) in the hamstring group. Again, no significant difference was observed between groups.

DISCUSSION

This study demonstrates a level of post-operative differential laxity control using TLS comparable with that of the ACL reconstruction technique using a hamstring graft with preserved tibial insertion.

LEVEL OF EVIDENCE

II, prospective cohort study.

摘要

引言

本研究的目的是评估采用单根肌腱(半腱肌四股肌腱)通过胫骨隧道扩大技术(TLS)重建前交叉韧带(ACL)后的不同松弛度,并与使用股薄肌和半腱肌的腘绳肌技术进行比较。我们假设这种手术技术在术后提供的不同松弛度测量结果至少与腘绳肌技术一样好。

材料与方法

我们对2014年12月至2016年6月期间接受单侧前交叉韧带修复的患者进行了一项前瞻性单中心研究。所有患者均随访至少12个月。该系列研究比较了由同一位外科医生使用TLS技术进行手术的61例患者与由另一位外科医生使用腘绳肌技术进行手术的33例患者。该研究的主要目的是比较两种技术术后使用KT1000测量的不同松弛度。

结果

两组患者的流行病学特征和术前评分无显著差异。TLS组术前平均不同松弛度为6.5mm±2.1(最小值3;最大值12),腘绳肌组为6.4mm±2.0(最小值0;最大值11),无统计学显著差异。TLS组术后松弛度平均差异为-0.1mm±1.9(最小值-5;最大值4),腘绳肌组为0.3mm±2.0(最小值-7;最大值5)。两组之间同样未观察到显著差异。

讨论

本研究表明,使用TLS技术术后的不同松弛度控制水平与保留胫骨附着点的腘绳肌移植ACL重建技术相当。

证据级别

II级,前瞻性队列研究。

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