Lubis Andri Mt, Dasril Demy Faheem
Department of Orthopaedic & Traumatology, Faculty of Medicine Universitas Indonesia - Ciptomangunkusumo Hospital, Indonesia.
Ann Med Surg (Lond). 2020 Nov 13;60:509-514. doi: 10.1016/j.amsu.2020.11.023. eCollection 2020 Dec.
ACL rupture has a high morbidity in productive-age population. The increasing incidence and proper management has become a point of interest in the musculoskeletal sport injury. Choosing the best graft has become the main focus in searching for a better outcome regarding ACL reconstruction in these patient population. Currently, single bundle hamstring tendon (SBHT) autograft was preferred in Asian population compared to bone quadriceps tendon (BQT) autograft. However, there are some problems such as short and small in diameter of SBHT. This study is focused on evaluation of the clinical outcome between BQT and SBHT in arthroscopic-assisted ACL reconstruction patients.
In this prospective cohort study, 30 subjects were divided into 2 groups (BQT and SBHT). Sampling was taken between February 2017-2018 (1 year) in one orthopaedic center. The instruments used for evaluation are rolimeter and patient-reported outcome (PRO) questionnaires (IKDC, Tegner-Lysholm, and KOOS) with data mining between 3 months, 6 months, and 1 year post operation. This study has been reported in line with the STROCSS criteria.
Mean difference of quadriceps (3.12 ± 0.94) and hamstring (3.87 ± 0.61) in rolimeter measurement 1 year post operation is statistically significant (p = 0.015). Side-to-side difference shows better result in quadriceps (0.34 ± 0.70) compared to hamstring (0.84 ± 0.60) with p value 0.04. IKDC scores in one month (p = 0.002; CI95% [8.81-31.79]) and three months (p = 0.004; CI95% [4.85-20.39]) post operative is better in quadriceps group. assessment 1 month post operative showed consistent results between numeric (p = 0.004) and categoric data (p = 0.050) in quadriceps group. There was an improvement during six months and one year post operative KOOS sub-item scales; pain (p = 0.034) and symptoms (p = 0.001).
Functional outcome of patient undergoing arthroscopic-assisted ACL reconstruction is better in BQT group compared to SBHT group, both in subjective and objective parameters given.
前交叉韧带（ACL）断裂在生育年龄人群中发病率较高。其发病率的上升及恰当的治疗已成为肌肉骨骼运动损伤领域的一个关注点。选择最佳移植物已成为在这些患者群体中寻求更好的ACL重建效果的主要焦点。目前，与骨四头肌肌腱（BQT）自体移植物相比，亚洲人群更倾向于单束腘绳肌腱（SBHT）自体移植物。然而，SBHT存在一些问题，如长度较短且直径较小。本研究聚焦于评估关节镜辅助下ACL重建患者中BQT和SBHT的临床效果。
在这项前瞻性队列研究中，30名受试者被分为2组（BQT组和SBHT组）。于2017年2月至2018年（1年）期间在一家骨科中心进行抽样。用于评估的工具为旋转计和患者报告结局（PRO）问卷（国际膝关节文献委员会（IKDC）、泰格纳 - 利霍尔姆（Tegner-Lysholm）和膝关节损伤与骨关节炎疗效评分（KOOS）），在术后3个月、6个月和1年进行数据挖掘。本研究已按照STROCSS标准进行报告。
术后1年旋转计测量中，四头肌（3.12±0.94）和腘绳肌（3.87±0.61）的平均差异具有统计学意义（p = 0.015）。左右侧差异显示，四头肌（0.34±0.70）的结果优于腘绳肌（0.84±0.60），p值为0.04。术后1个月（p = 0.002；95%置信区间[8.81 - 31.79]）和3个月（p = 0.004；95%置信区间[4.85 - 20.39]）时，BQT组的IKDC评分更高。术后1个月的评估显示，BQT组在数值数据（p = 0.004）和分类数据（p = 0.050）方面结果一致。术后6个月和1年KOOS子项量表有改善；疼痛（p = 0.034）和症状（p = 0.001）。
在关节镜辅助下ACL重建患者中，无论是主观还是客观参数，BQT组的功能结局均优于SBHT组。
