使用自体腓骨长肌腱前半段进行全关节镜下前交叉韧带重建术
All-Inside Anterior Cruciate Ligament Reconstruction Using an Anterior Half of the Peroneus Longus Tendon Autograft.
作者信息
Bi Mingguang, Zhao Chen, Zhang Qiong, Cao Li, Chen Xinji, Kong Mingxiang, Bi Qing
机构信息
Ningbo Medical Center, Lihuili Hospital, Ningbo University School of Medicine, Ningbo, China.
Department of Orthopaedic Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.
出版信息
Orthop J Sports Med. 2021 Jun 17;9(6):2325967121991226. doi: 10.1177/2325967121991226. eCollection 2021 Jun.
BACKGROUND
The peroneus longus tendon (PLT) has been used as a graft in many orthopaedic surgical procedures because of its comparable biomechanical strength with the native anterior cruciate ligament (ACL). Despite its potential, few studies have been performed to investigate the clinical reliability of ACL reconstruction using a PLT autograft.
PURPOSE
To assess the clinical outcomes and donor-site morbidity of ACL reconstruction using an anterior half of the PLT (AHPLT) autograft in patients with an isolated ACL injury.
STUDY DESIGN
Case series; Level of evidence, 4.
METHODS
Between January 2016 and January 2017, a total of 21 patients with an isolated ACL injury underwent all-inside single-bundle ACL reconstruction using an AHPLT autograft. Knee stability was assessed using the Lachman test, pivot-shift test, and KT-2000 arthrometer (side-to-side difference) with 134-N anterior force and at 30° of knee flexion. Knee function was evaluated using the International Knee Documentation Committee score, Lysholm score, and Tegner score. Donor-site morbidity was assessed using ankle eversion and plantarflexion strength as well as the American Orthopaedic Foot & Ankle Society scoring system and the Foot and Ankle Disability Index.
RESULTS
At a mean final follow-up of 40.1 months (range, 36-48 months), the KT-2000 arthrometer side-to-side difference was significantly lower compared with preoperatively (1.1 ± 0.62 vs 7.0 ± 2.18 mm, respectively; < .001). The mean preoperative International Knee Documentation Committee, Lysholm, and Tegner scores were 52.0 ± 8.27, 50.9 ± 8.50, and 1.8 ± 0.87, respectively, increasing significantly to 94.2 ± 2.61, 95.2 ± 2.64, and 6.8 ± 1.50, respectively, at final follow-up ( < .001 for all). All patients had grade 5 muscle strength in ankle eversion and plantarflexion at the donor site, with mean American Orthopaedic Foot & Ankle Society and Foot and Ankle Disability Index scores of 96.8 and 97.6, respectively. No complications or reoperations occurred.
CONCLUSION
All-inside ACL reconstruction using an AHPLT autograft produced good functional scores and stability without obvious ankle-site morbidity.
背景
由于腓骨长肌腱（PLT）与天然前交叉韧带（ACL）具有相当的生物力学强度，因此在许多骨科手术中已被用作移植物。尽管有其潜力，但很少有研究调查使用PLT自体移植物进行ACL重建的临床可靠性。
目的
评估使用PLT前半部分（AHPLT）自体移植物对孤立性ACL损伤患者进行ACL重建的临床结果和供区并发症。
研究设计
病例系列；证据等级，4级。
方法
2016年1月至2017年1月期间，共有21例孤立性ACL损伤患者接受了使用AHPLT自体移植物的全关节镜下单束ACL重建。使用Lachman试验、轴移试验和KT-2000关节测量仪（两侧差异），在膝关节屈曲30°时施加134 N的前向力来评估膝关节稳定性。使用国际膝关节文献委员会评分、Lysholm评分和Tegner评分来评估膝关节功能。使用踝关节外翻和跖屈力量以及美国矫形足踝协会评分系统和足踝残疾指数来评估供区并发症。
结果
在平均最终随访40.1个月（范围36 - 48个月）时，KT-2000关节测量仪两侧差异与术前相比显著降低（分别为1.1±0.62 mm和7.0±2.18 mm；P <.001）。术前国际膝关节文献委员会、Lysholm和Tegner评分的平均值分别为52.0±8.27、50.9±8.50和1.8±0.87，在最终随访时分别显著提高到94.2±2.61、95.2±2.64和6.8±1.50（所有P <.001）。所有患者供区踝关节外翻和跖屈肌力均为5级，美国矫形足踝协会和足踝残疾指数评分的平均值分别为96.8和97.6。未发生并发症或再次手术。
结论
使用AHPLT自体移植物进行全关节镜下ACL重建可产生良好的功能评分和稳定性，且无明显的踝关节供区并发症。
Zotero 插件