Orthopaedics and Traumatology Department, Tekirdag Namik Kemal University Medical Faculty, Namik Kemal District Kampus Street 1/14, 59100, Süleymanpasa, Tekirdag, Turkey.
Orthopaedics and Traumatology Department, Istanbul Sisli Kolan International Hospital, Kaptanpasa District, Darulaceza Street Number: 14 Okmeydanı, Sisli, İstanbul, Turkey.
Arch Orthop Trauma Surg. 2021 Jun;141(6):977-985. doi: 10.1007/s00402-020-03748-1. Epub 2021 Jan 13.
Sports injuries are increasing today due to the increased interest in sports. The most common injured knee ligament is the anterior cruciate ligament (ACL) in sport injuries. Accordingly, surgical treatment of the ACL is performed frequently. In this study, it was aimed to retrospectively evaluate whether the location of an endobutton on lateral knee radiography was effective on knee functional scores in patients who underwent ACL reconstruction.
One hundred thirty patients who underwent ACL reconstruction between January 2015 and February 2019 were identified. The patients were divided into three groups according to the location of the endobutton on lateral radiographs taken in the postoperative period. Group 1 patients were classified as anterior, group 2 as middle, and group 3 as posterior according to the location of the endobutton. Functional scoring, physical examination tests, comparative thigh diameter measurements, and single-leg hop tests were compared between the groups. It was evaluated as to whether there was a statistically significant difference between the groups.
There were 38 patients in group 1, 63 patients in group 2, and 29 patients in group 3. The mean age was 29.1 in group 1, 29.1 in group 2, and 29.7 in group 3. The mean follow-up period of the patients was 18.4 months in group 1, 19.1 months in group 2, and 21.4 months in group 3. The average Lysholm score was 92.9 in group 1, 93.3 in group 2, and 91.7 in group 3. The mean modified Cincinnati scores were 27.0, 27.1, and 26.6, respectively, in the groups. The mean IKDC score of the subjective knee assessments was 92.5, 92.8, and 91, respectively, according to the groups. The average thigh atrophy value was 1 cm, 1 cm, and 1.2 cm, respectively, in the groups. In the single-leg hop test, 34 patients in group 1 jump to over 85% of the distance compared with the intact side, while 58 patients in group 2, and 23 patients in group 3 were successfully able to jump this distance. The effect of the placement of the endobutton in the anterior, middle or posterior was not statistically significant on functional scores and physical examination results. In patients with endobuttons in the middle, functional scores were found better than in those with anterior or posterior placement.
No statistically significant differences were found in clinical functional results when comparing patients' endobutton location on femur. For this reason, surgical time should not be extended using unnecessary extra effort to change the orientation of the exit hole during surgery.
由于人们对体育运动的兴趣增加，今天运动损伤越来越多。运动损伤中最常见的膝关节韧带损伤是前交叉韧带（ACL）。因此，ACL 的手术治疗经常进行。在这项研究中，我们旨在回顾性评估接受 ACL 重建的患者中，外侧膝关节 X 线片上 Endobutton 的位置是否对膝关节功能评分有影响。
确定了 2015 年 1 月至 2019 年 2 月期间接受 ACL 重建的 130 名患者。根据术后拍摄的外侧 X 光片上 Endobutton 的位置，将患者分为三组。根据 Endobutton 在 X 光片上的位置，第 1 组患者被分为前组，第 2 组为中组，第 3 组为后组。对各组进行功能评分、体格检查、大腿直径测量和单腿跳跃测试。评估各组之间是否存在统计学差异。
第 1 组有 38 例患者，第 2 组有 63 例患者，第 3 组有 29 例患者。第 1 组的平均年龄为 29.1 岁，第 2 组为 29.1 岁，第 3 组为 29.7 岁。第 1 组患者的平均随访时间为 18.4 个月，第 2 组为 19.1 个月，第 3 组为 21.4 个月。第 1 组的平均 Lysholm 评分为 92.9，第 2 组为 93.3，第 3 组为 91.7。各组的改良 Cincinnati 评分分别为 27.0、27.1 和 26.6。根据各组，主观膝关节评估的 IKDC 评分分别为 92.5、92.8 和 91。大腿萎缩值平均为 1cm、1cm 和 1.2cm。在单腿跳跃测试中，第 1 组中有 34 名患者跳跃距离超过健侧的 85%，而第 2 组中有 58 名患者，第 3 组中有 23 名患者成功跳跃了这个距离。Endobutton 在股骨中的位置在前、中或后，对功能评分和体格检查结果没有统计学意义。在 Endobutton 位于中间的患者中，功能评分好于位于前或后的患者。
当比较患者股骨上 Endobutton 的位置时，在临床功能结果方面没有发现统计学上的显著差异。因此，在手术过程中，不应该为了改变出口孔的方向而延长手术时间，使用不必要的额外努力。
