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比较使用股四头肌腱与半腱肌腱移植进行解剖学前交叉韧带重建后的膝关节松弛度。

Comparing Knee Laxity After Anatomic Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Versus Semitendinosus Tendon Graft.

作者信息

Karpinski Katrin, Häner Martin, Bierke Sebastian, Diermeier Theresa, Petersen Wolf

机构信息

Martin Luther Hospital, Berlin, Germany.

Klinikum Rechts der Isar, Munich, Germany.

出版信息

Orthop J Sports Med. 2021 Jul 21;9(7):23259671211014849. doi: 10.1177/23259671211014849. eCollection 2021 Jul.

Abstract

BACKGROUND

The choice of graft in anterior cruciate ligament (ACL) reconstruction is still under discussion. The hamstrings are currently the most used grafts for primary ACL reconstruction in Europe. However, increased interest has arisen in the quadriceps tendon (QT) as an alternative autologous graft option for primary ACL reconstruction.

PURPOSE

To evaluate knee stability and the subjective outcome after ACL reconstruction using either autologous QT graft in implant-free femoral press-fit fixation technique or semitendinosus tendon (ST) graft.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

We evaluated 50 patients who underwent ACL reconstruction, including 25 patients who received autologous ipsilateral QT graft (QT group) and 25 patients who received the ipsilateral ST graft (ST group). The follow-up for this prospective comparative study was at least 2 years after surgery, comprising KT-1000 arthrometer testing, pivot-shift test, Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, and rerupture rate.

RESULTS

The mean patient age was 31.72 years (9 women, 16 men) in the QT group and 32.08 years (13 women, 12 men) in the ST group. The mean ± standard deviation postoperative side-to-side difference assessed using KT-1000 arthrometer was 1.56 ± 1.56 mm for the QT group and 1.64 ± 1.41 mm for the ST group, with no significant difference. No significant difference was found on any of the KOOS subscale scores ( = .694) or the Lysholm score ( = .682). No rerupture or positive pivot-shift test occurred during follow-up. No difference was found in donor-site morbidity between the study groups.

CONCLUSION

Clinical outcomes were not significantly different between QT and ST grafts in the current study. Thus, the QT may serve as a good alternative graft for primary ACL reconstruction.

摘要

背景

前交叉韧带(ACL)重建中移植物的选择仍在讨论中。在欧洲,腘绳肌腱目前是初次ACL重建中使用最多的移植物。然而,股四头肌肌腱(QT)作为初次ACL重建的一种自体移植物替代选择,其关注度日益增加。

目的

使用无植入物股骨压配固定技术的自体QT移植物或半腱肌腱(ST)移植物评估ACL重建后的膝关节稳定性和主观结果。

研究设计

队列研究;证据等级,2级。

方法

我们评估了50例行ACL重建的患者,其中25例接受自体同侧QT移植物(QT组),25例接受同侧ST移植物(ST组)。这项前瞻性比较研究的随访时间为术后至少2年,包括KT-1000关节测量仪测试、轴移试验、膝关节损伤和骨关节炎疗效评分(KOOS)、Lysholm评分以及再断裂率。

结果

QT组患者平均年龄为31.72岁(9名女性,16名男性),ST组为32.08岁(13名女性,12名男性)。使用KT-1000关节测量仪评估的术后平均±标准差侧方差异,QT组为1.56±1.56 mm,ST组为1.64±1.41 mm,无显著差异。在KOOS各子量表评分(P = 0.694)或Lysholm评分(P = 0.682)上均未发现显著差异。随访期间未发生再断裂或阳性轴移试验。研究组之间供区并发症无差异。

结论

在本研究中,QT和ST移植物的临床结果无显著差异。因此,QT可作为初次ACL重建的良好替代移植物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9590/8312171/898369e99c82/10.1177_23259671211014849-fig1.jpg

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