五股和六股腘绳肌腱移植物可始终为前交叉韧带重建提供合适的移植物直径。
Five- and six-strand hamstring grafts consistently produce appropriate graft diameters for anterior cruciate ligament reconstruction.
机构信息
Western University, London, Canada.
Orthopaedic Surgery, London Health Sciences Centre, London, Canada.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2021 Sep;29(9):2940-2947. doi: 10.1007/s00167-020-06313-w. Epub 2020 Oct 9.
PURPOSE
Hamstring tendon graft diameter less than 8 mm has been correlated with an increased risk of anterior cruciate ligament reconstruction (ACLR) graft failure. The purpose of this study was to measure and compare the diameter of 3-, 4-, 5-, and 6-strand gracilis and semitendinosus (ST) hamstring tendon (HT) ACLR grafts, and to determine if there is a correlation between anthropometric data, HT length, and diameter of the HT ACLR graft.
METHODS
Male patients (n = 78) undergoing primary or revision ACLR with a HT autograft between July 2018 and March 2020 were recruited. Pre-operative anthropometric data was collected. Gracilis and ST tendons were harvested and the length and diameter measured. The following HT graft configurations were prepared in each patient: triple ST; double gracilis + double ST; double gracilis + triple ST; triple gracilis + triple ST. Paired t-tests and Pearson's correlation coefficients were used to assess demographics, anthropometrics, graft diameter, and tendon length. A non-parametric test was used to compare femoral and tibial ACL graft diameters of the 3-, 4-, 5-, and 6-strand HT graft configurations.
RESULTS
For the femoral end, 10%, 19%, 69% and 86% of the patients achieved graft diameters of equal to or greater than 8 mm in 3-, 4-, 5- and 6-strand HT graft configurations respectively. For the tibial end, 27%, 10%, 83%, and 92% of the patients achieved graft diameters of equal to or greater than 8 mm in 3-, 4-, 5-, and 6-strand HT graft configurations respectively. The largest increases in HT graft diameters were noted between the femoral end of 6- vs. 3-strand grafts (mean difference 1.7 ± 0.5 mm; p < 0.001) and between the tibial end of 6- vs. 4-strand grafts (mean difference 2.0 ± 0.5 mm; p < 0.001). Height and leg length were moderately positively correlated with ST tendon length (r = 0.54-0.51) and gracilis tendon length (r = 0.52-0.45), and thigh and shank lengths were moderately positively correlated with ST tendon length (r = 0.43 and 0.40, respectively).
CONCLUSION
Traditional 4-strand HT ACL autografts in male patients undergoing ACLR in the United Arab Emirates result in graft diameters less than 8 mm in the majority of patients.
LEVEL OF EVIDENCE
III.
目的
腘绳肌腱移植物直径小于 8 毫米与前交叉韧带重建 (ACLR) 移植物失败的风险增加有关。本研究的目的是测量和比较 3 股、4 股、5 股和 6 股股薄肌和半腱肌 (ST) 腘绳肌腱 (HT) ACLR 移植物的直径，并确定人体测量数据、HT 长度和 HT ACLR 移植物直径之间是否存在相关性。
方法
招募了 2018 年 7 月至 2020 年 3 月期间接受 HT 自体移植物进行原发性或复发性 ACLR 的男性患者 (n=78)。收集术前人体测量数据。采集股薄肌和半腱肌腱，并测量长度和直径。在每位患者中制备以下 HT 移植物构型：三联 ST；双股薄肌+双股 ST；双股薄肌+三联 ST；三联股薄肌+三联 ST。使用配对 t 检验和 Pearson 相关系数评估人口统计学、人体测量学、移植物直径和肌腱长度。使用非参数检验比较 3 股、4 股、5 股和 6 股 HT 移植物构型的股骨和胫骨 ACL 移植物直径。
结果
对于股骨端，在 3 股、4 股、5 股和 6 股 HT 移植物构型中，分别有 10%、19%、69%和 86%的患者达到了等于或大于 8 毫米的移植物直径。对于胫骨端，在 3 股、4 股、5 股和 6 股 HT 移植物构型中，分别有 27%、10%、83%和 92%的患者达到了等于或大于 8 毫米的移植物直径。在股骨端，6 股与 3 股移植物之间（平均差异 1.7±0.5 毫米；p<0.001）和胫骨端 6 股与 4 股移植物之间（平均差异 2.0±0.5 毫米；p<0.001）观察到 HT 移植物直径的最大增加。身高和腿长与 ST 肌腱长度（r=0.54-0.51）和股薄肌肌腱长度（r=0.52-0.45）呈中度正相关，大腿和小腿长度与 ST 肌腱长度呈中度正相关（r=0.43 和 0.40）。
结论
在阿拉伯联合酋长国接受 ACLR 的男性患者中，传统的 4 股 HT ACL 自体移植物导致大多数患者的移植物直径小于 8 毫米。
证据水平
III。
Zotero 插件