Mae Tatsuo, Shimomura Kazunori, Ohori Tomoki, Hirose Takehiko, Taketomi Shuji, Suzuki Tomoyuki, Nakata Ken
Department of Sports Medical Biomechanics, Osaka University Graduate School of Medicine, Osaka.
Department of Orthopaedics Surgery, Osaka University Graduate School of Medicine, Osaka.
Arthrosc Sports Med Rehabil. 2021 Aug 13;3(5):e1337-e1341. doi: 10.1016/j.asmr.2021.06.003. eCollection 2021 Oct.
To compare the suture slippage on a hamstring tendon graft prepared with a modified finger-trap device (SPEEDTRAP) with one prepared with Krackow stitch during graft passage through the tibial tunnel in ACL reconstruction.
Thirty-eight patients underwent anatomic triple-bundle anterior cruciate ligament reconstruction with 2 femoral and 3 tibial tunnels. After semitendinosus tendon was cut in half to make 2 grafts, the free ends of the proximal membranous portion (posterolateral [PL] graft) were prepared together with 2 sutures: (1) one SPEEDTRAP and one Krackow stitch for 20 cases (group A) and (2) double Krackow stitches on both sides for 18 cases (group B). Then, the PL graft was dye-marked at the proximal suture of SPEEDTRAP in group A and Krackow suture in group B and was inserted into the joint via tibial tunnel ahead of the loop side. The distance between the mark on the graft and the proximal suture of SPEEDTRAP or Krackow stitch was measured under arthroscopy after graft fixation at femur. Slippage was defined as 1 mm and more of distance between the mark and the proximal suture.
Slippage was observed in 16 cases for SPEEDTRAP and in 2 for Krackow suture in group A, whereas one case showed slippage in group B. The slippage distance was 4.0 ± 2.9 mm for SPEEDTRAP and 0.2 ± 0.5 mm for Krackow stitch in group A ( < .001), whereas it was 0.1 ± 0.2 mm for double Krackow stitch in group B, showing a significant difference from SPEEDTRAP suture ( < .001).
At the time of PL graft passage through the tibial tunnel in anterior cruciate ligament reconstruction, there was significantly less slippage observed with the Krackow stitch compared with the SPEEDTRAP stitch.
Level IV, therapeutic case series.
比较在 ACL 重建术中，使用改良指套装置（SPEEDTRAP）制备的绳肌腱移植物与使用 Krackow 缝合法制备的移植物在通过胫骨隧道时的缝线滑移情况。
38 例患者接受了具有 2 个股骨隧道和 3 个胫骨隧道的解剖学三束前交叉韧带重建术。将半腱肌腱切成两半制成 2 个移植物后，近端膜部（后外侧[PL]移植物）的游离端用 2 根缝线进行制备：（1）20 例采用 1 个 SPEEDTRAP 和 1 个 Krackow 缝合法（A 组），（2）18 例在两侧采用双 Krackow 缝合法（B 组）。然后，在 A 组中，PL 移植物在 SPEEDTRAP 的近端缝线处进行染料标记，在 B 组中在 Krackow 缝线处进行染料标记，并在环侧之前通过胫骨隧道插入关节。在股骨上固定移植物后，在关节镜下测量移植物上的标记与 SPEEDTRAP 或 Krackow 缝线近端缝线之间的距离。滑移定义为标记与近端缝线之间的距离为 1mm 及以上。
A 组中，SPEEDTRAP 观察到 16 例滑移，Krackow 缝合法观察到 2 例滑移，而 B 组有 1 例出现滑移。A 组中，SPEEDTRAP 的滑移距离为 4.0±2.9mm，Krackow 缝合法为 0.2±0.5mm（P<0.001），而 B 组双 Krackow 缝合法的滑移距离为 0.1±0.2mm，与 SPEEDTRAP 缝线相比有显著差异（P<0.001）。
在前交叉韧带重建术中 PL 移植物通过胫骨隧道时，与 SPEEDTRAP 缝线相比，Krackow 缝合法观察到的滑移明显更少。
IV 级，治疗性病例系列。
