Deng Nan-Ling, Zhang Lei, Sun Jin, Ma Jia, Zhang Sheng, Liu Xiao-Hua, Jiang Bo, Li Yan
Forth Department of Joint, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China.
Zhongguo Gu Shang. 2021 Mar 25;34(3):269-74. doi: 10.12200/j.issn.1003-0034.2021.03.016.
To compare the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) with a tibialis anterior allograft (TAA)versus hamstring tendon autograft (HTA) after 10 years follow-up.
A clinical data of 107 patients who underwent arthroscopic ACLR with a single bundle tendon between March 2007 and March 2010 was retrospectively analyzed. Among the patients, 48 patients were reconstructed with a tibialis anterior allograft (TAA group), including 26 males and 22 females, ranging in age from 16 to 38 years, with a mean of 27.2±6.2 years;59 patients were reconstructed with a hamstring tendon autograft (HTA group), including 31 males and 28 females, ranging in age from 16 to 40 years, with a mean of 28.0±7.6 years. The preoperative tibial anterior displacement and knee joint function, as well as knee joint stability, tibial anterior displacement and knee joint function at 10 years after operation were observed. Lachman test was used to evaluate the forward joint stability and pivot shift test to evaluate the rotational stability of the knee;KT-2000 side-to-side difference (SSD) was used to measure tibial anterior displacement;International Knee Documentation Committee(IKDC) score and Lysholm score were used to evaluate knee function.
The incisions of both groups were healed by first intention, and no early complications occurred after operation. All patients were followed-up 10 to 13 years, the mean time was 11.7 years. There was no graft failure were found during the follow up period. The KT-2000 SSD of the TAA group and the HTA group at ten years after operation were 1.9±0.7 and 1.8±0.6 respectively, which were significantly improved than 8.8±0.9 and 8.6±1.0 preoperatively(<0.05), but there were no significant difference between the two groups(>0.05). The total Lysholm score of the TAA group and the HTA group at ten years after operation were 90.4±4.4 and 90.7±3.4 respectively, which were significantly improved than 51.4±13.3 and 51.2±14.6 preoperatively(<0.05), but there were no significant difference between the two groups(>0.05). The total IKDC score of the TAA group and the HTA group at ten years after operation were 91.5±4.1 and 90.9±3.2 respectively, which were significantly improved than 45.8±12.2 and 47.0±14.5 preoperatively(<0.05), but there were no significant difference between the two groups(>0.05). No significant difference were found between the two groups in Lachman test and pivot shift test at 10 years after operation (>0.05).
The TAA and HTA have equal long term effect in ACL reconstruction, doctors and patients can choose the graft according to the actual situation.
比较在10年随访后，关节镜下采用胫骨前肌异体移植（TAA）与腘绳肌腱自体移植（HTA）进行前交叉韧带重建（ACLR）的临床效果。
回顾性分析2007年3月至2010年3月间107例行单束肌腱关节镜下ACLR患者的临床资料。其中，48例患者采用胫骨前肌异体移植重建（TAA组），包括男性26例，女性22例，年龄16至38岁，平均（27.2±6.2）岁；59例患者采用腘绳肌腱自体移植重建（HTA组），包括男性31例，女性28例，年龄16至40岁，平均（28.0±7.6）岁。观察术前胫骨前移及膝关节功能，以及术后10年时膝关节稳定性、胫骨前移及膝关节功能。采用Lachman试验评估关节前向稳定性，采用轴移试验评估膝关节旋转稳定性；采用KT-2000两侧差值（SSD）测量胫骨前移；采用国际膝关节文献委员会（IKDC）评分和Lysholm评分评估膝关节功能。
两组切口均一期愈合，术后均未发生早期并发症。所有患者随访10至13年，平均随访时间为11.7年。随访期间未发现移植物失败。术后10年TAA组和HTA组的KT-2000 SSD分别为（1.9±0.7）和（1.8±0.6），较术前的（8.8±0.9）和（8.6±1.0）均显著改善（<0.05），但两组间差异无统计学意义（>0.05）。术后10年TAA组和HTA组的Lysholm总分分别为（90.4±4.4）和（90.7±3.4），较术前的（51.4±13.3）和（51.2±14.6）均显著改善（<0.05），但两组间差异无统计学意义（>0.05）。术后10年TAA组和HTA组的IKDC总分分别为（91.5±4.1）和（90.9±3.2），较术前的（45.8±12.2）和（47.0±14.5）均显著改善（<0.05），但两组间差异无统计学意义（>0.05）。术后10年两组在Lachman试验和轴移试验中差异无统计学意义（>0.05）。
TAA和HTA在ACL重建中具有同等的长期效果，医生和患者可根据实际情况选择移植物。
