Department of Orthopaedic and Traumatologic Surgery, Hospital Znojmo, MUDr. Jana Jánského 11, 669 02, Znojmo, Czech Republic.
Department of Health Promotion-Division of Physiotherapy, Faculty of Sports Studies, Masaryk University, Kamenice 5, Brno, Czech Republic.
Arch Orthop Trauma Surg. 2022 Aug;142(8):1995-1999. doi: 10.1007/s00402-021-04195-2. Epub 2021 Oct 3.
The aim of this prospective randomised study was to evaluate clinical results and rotational stability at least 2 years after single-bundle anatomic anterior cruciate ligament reconstruction using a quadriceps tendon graft with bone block (BT) and bone-patellar tendon-bone graft (BTB).
In both groups (BT and BTB), 40 patients selected prospectively at random were evaluated. The mean follow-up after the surgery was 28 months (range 24-33 months). A navigation system was used to measure rotational stability of the knee joint. Cincinnati, Lysholm, and IKDC scores and visual analog score (VAS) were used to evaluate clinical results and the non-parametric Wilcoxon test was used for the statistical analysis.
After the BT reconstruction, the mean internal rotation of the tibia (IR) was 9.5°. In the contralateral healthy knee joint, IR was 8.6° at average. After the BTB reconstruction, the mean IR was 9.9°. In the contralateral healthy knee joint, IR was 8.7° at average. We did not find any statistically significant difference in IR stability between BT and BTB reconstruction. In terms of clinical results, regarding the VAS, patients perceive significantly more pain after the BTB reconstruction (p < 0.05). Kneeling was reported more difficult and painful after BTB reconstruction.
The BT reconstruction of the ACL provides similar clinical results, less pain, better flexion and the same rotational stability of the knee in comparison with the BTB reconstruction.
本前瞻性随机研究的目的是评估使用带骨块的四头肌腱移植物(BT)和骨-髌腱-骨移植物(BTB)进行单束解剖前交叉韧带重建后至少 2 年的临床结果和旋转稳定性。
在 BT 和 BTB 两组中,前瞻性随机选择 40 例患者进行评估。术后平均随访 28 个月(范围 24-33 个月)。使用导航系统测量膝关节的旋转稳定性。使用辛辛那提、Lysholm 和 IKDC 评分以及视觉模拟评分(VAS)评估临床结果,并使用非参数 Wilcoxon 检验进行统计分析。
BT 重建后,胫骨内旋(IR)的平均为 9.5°。在对侧健康膝关节中,IR 平均为 8.6°。BTB 重建后,IR 的平均为 9.9°。在对侧健康膝关节中,IR 平均为 8.7°。我们没有发现 BT 和 BTB 重建之间在 IR 稳定性方面有统计学上的显著差异。在临床结果方面,关于 VAS,BTB 重建后患者感到明显更疼痛(p<0.05)。BTB 重建后,患者报告更难以跪下且更痛苦。
与 BTB 重建相比,BT 重建 ACL 提供了相似的临床结果、更少的疼痛、更好的屈曲和相同的膝关节旋转稳定性。