Alkhalaf Fahad N A, Hanna Sager, Alkhaldi Mohammed Saleh Hattab, Alenezi Fares, Khaja Aliaa
SICOT J. 2021;7:16. doi: 10.1051/sicotj/2021018. Epub 2021 Mar 22.
Anterior cruciate ligament injuries are commonly seen in orthopedic surgery practice. Although anterior cruciate ligament reconstruction (ACLR) has come a long way, the causes of failure have yet to be fully understood.
The aim of this study was to investigate whether or not the intraoperative 4-strand hamstring autograft diameter does in fact influence the failure rates of ACLR.
Retrospective intraoperative data were collected from ACLR patients from the only tertiary center available in Kuwait. Patients who underwent ACLR from 2012 to 2018 for isolated ACL injuries were included in this study, allowing for a 24 month follow-up period The cohorts were categorized into 3 groups: patients with graft size≤8mm, 2, patients with graft sizes≥8mm with 4-strands and patients with graft sizes≥8mm with 4-strands or more. ANOVA analysis was applied to address group differences between mean graft size and strand numbers and subsequently the failure rates for each group. In addition, the Mann-Whitney U test was used to investigate the relationship between revision and initial ACL graft size.
Out of the 711 out of 782 patients were included in this study. Only 42.6% of the patients did not need more than 4-strands to achieve an 8mm sized autograft. The patients who had autografts≤8mm in this study accounted for 17.1% of the population. About 7.2% of these patients required revision surgery. Patients with a 4-strand autograft size that was less than 8mm were 7.2 times more at risk for ACLR failure (RR=7.2, 95% CI: 6.02; 8.35, p=0.007).
There is a significant correlation between 4-strand autograft diameter size and the need for ACLR revision surgery.
IV case series.
前交叉韧带损伤在骨科手术中较为常见。尽管前交叉韧带重建术（ACLR）已经取得了长足的发展，但其失败原因尚未完全明确。
本研究旨在探讨术中4股腘绳肌自体移植物直径是否真的会影响ACLR的失败率。
从科威特唯一的三级中心收集ACLR患者的回顾性术中数据。本研究纳入了2012年至2018年因单纯前交叉韧带损伤接受ACLR的患者，并进行了24个月的随访。将队列分为3组：移植物尺寸≤8mm的患者、移植物尺寸≥8mm的4股患者以及移植物尺寸≥8mm的4股及以上患者。采用方差分析来处理平均移植物尺寸和股数之间的组间差异，以及随后每组的失败率。此外，使用曼-惠特尼U检验来研究翻修与初始前交叉韧带移植物尺寸之间的关系。
本研究纳入了782例患者中的711例。只有42.6%的患者不需要超过4股就能获得8mm大小的自体移植物。本研究中自体移植物≤8mm的患者占总人群的17.1%。这些患者中约7.2%需要翻修手术。4股自体移植物尺寸小于8mm的患者发生ACLR失败的风险高7.2倍（RR = 7.2，95%CI：6.02；8.35，p = 0.007）。
4股自体移植物直径大小与ACLR翻修手术的需求之间存在显著相关性。
IV级病例系列。
