Buyukkuscu Mehmet Ozbey, Misir Abdulhamit, Cetinkaya Engin, Ezici Atakan, Ozcafer Rasit, Gursu Sukru Sarper
Department of Orthopaedics and Traumatology, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey.
Department of Orthopaedics and Traumatology, Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey.
Knee. 2020 Jun;27(3):891-898. doi: 10.1016/j.knee.2020.02.021. Epub 2020 Mar 20.
In clinical practice, soft tissue interposition may occur during femoral graft fixation. Soft tissue interposition between the lateral femoral cortex and the cortical button may affect graft tension and related longitudinal graft motion in the tunnel. We aimed to investigate the effect of soft tissue interposition on button migration and clinical outcomes in anatomical single-bundle anterior cruciate ligament reconstruction.
Eighty-four patients aged 18-40 years, who underwent anatomical single-bundle anterior cruciate ligament reconstruction with quadruple hamstring autograft were included. Patients were divided into two groups as Group 1 (n = 32) with soft tissue interposition between the cortical button and cortex, and Group 2 (n = 52) without soft tissue interposition. At the one-year follow-up visit, the anteroposterior knee stability of the patients was evaluated using the Lachman test and KT-2000 arthrometer, and rotational stability was assessed with the pivot shift test. The Lysholm knee score was used to evaluate the functional outcome of the patients. Relationship between tissue interposition and clinical outcome, and button migration was examined.
Button migration was observed in 12 patients in Group 1 (37.5%) and two patients (3.84%) in Group 2 (p < 0.001). However, no significant difference was observed between patients with and without tissue interposition or those with and without button migration regarding knee stability parameters and clinical outcome (p < 0.05).
Postoperative tissue interposition is found to be associated with cortical button migration during the follow-up. However, it does not affect the clinical outcome.
在临床实践中，股骨移植物固定时可能会出现软组织嵌入。股骨外侧皮质与皮质纽扣之间的软组织嵌入可能会影响移植物张力以及移植物在隧道内的相关纵向移动。我们旨在研究软组织嵌入对解剖单束前交叉韧带重建中纽扣移位及临床结果的影响。
纳入84例年龄在18至40岁之间、接受了四股腘绳肌自体移植解剖单束前交叉韧带重建的患者。患者被分为两组，第1组（n = 32）皮质纽扣与皮质之间存在软组织嵌入，第2组（n = 52）无软组织嵌入。在一年的随访中，使用拉赫曼试验和KT-2000关节测量仪评估患者的膝关节前后稳定性，通过轴移试验评估旋转稳定性。采用Lysholm膝关节评分评估患者的功能结果。研究软组织嵌入与临床结果以及纽扣移位之间的关系。
第1组有12例患者（37.5%）出现纽扣移位，第2组有2例患者（3.84%）出现纽扣移位（p < 0.001）。然而，在膝关节稳定性参数和临床结果方面，有或无软组织嵌入的患者以及有或无纽扣移位的患者之间均未观察到显著差异（p < 0.05）。
术后随访发现软组织嵌入与皮质纽扣移位有关。然而，它并不影响临床结果。
