Joint Practice Renz' Volz and Loewe, Center for Specialized Joint Surgery, Haegerstraße 4, 88662, Ueberlingen, Germany.
Dr. Borchert Medical Information Management, Egelsbacher Str. 39e, 63225, Langen, Germany.
Arch Orthop Trauma Surg. 2023 Feb;143(2):935-949. doi: 10.1007/s00402-022-04368-7. Epub 2022 Mar 15.
There is currently no consensus regarding the preferred surgical procedure for the reconstruction of anterior cruciate ligament (ACL). The interference screw technique is widely used, but has been associated with a risk of graft damage. The Press-Fit-Hybrid®-technique is one of the alternatives for biological ACL-reconstruction with minimal implant requirements. The hypothesis of this retrospective analysis is, that the Press-Fit-Hybrid®-technique leads to better results with respect to re-rupture rate and secondary meniscal lesion than the interference-screw-technique.
To compare the re-rupture rate of the interference-screw-technique (IF) used until 2015 with the currently used Press-Fit-Hybrid®-technique (PFH), the last 100 patients of the IF-group and the first 100 patients of the PFH-group were retrospectively analyzed. Primary outcomes were re-rupture rate, complications and secondary meniscal injury. Additionally, laxity, Lachman and Pivot-shift and range of motion were evaluated.
A mean follow-up of 4.2 and 5.3 years revealed 4% and 9% re-rupture rates and 1% and 2% complication rates in the PFH- and IF-group, respectively. In the PFH-group there were no re-ruptures in patients older than 23 years. Secondary meniscal injury post-surgery was 6% and 9% for the PFH and IF-group, respectively. Knee stability was similar in both groups. Range of motion was significantly better in the PFH-group, with 136° of flexion, 6 months after surgery.
For ACL-reconstruction the Press-Fit-Hybrid®-technique is an alternative new method. Low level of secondary meniscal lesions after surgery and high stability, is known to prevent later arthrosis of the knee. The encouraging observed trend of the reduction of the re-rupture rate in revision surgery and in young patients using the Press-Fit-Hybrid®-technique in comparison to the interference-screw-technique must be confirmed with further studies.
Therapeutic Level III, retrospective cohort study.
目前对于前交叉韧带（ACL）重建的首选手术方法尚未达成共识。干扰螺钉技术被广泛应用，但存在移植物损伤的风险。压配混合®技术是对 ACL 进行生物重建的替代方法之一，所需植入物较少。本回顾性分析的假设是，与干扰螺钉技术相比，压配混合®技术在再撕裂率和继发半月板损伤方面具有更好的效果。
为了比较直到 2015 年使用的干扰螺钉技术（IF）和当前使用的压配混合®技术（PFH）的再撕裂率，回顾性分析了 IF 组的最后 100 例患者和 PFH 组的前 100 例患者。主要结局是再撕裂率、并发症和继发半月板损伤。此外，还评估了松弛度、Lachman 和 Pivot-shift 以及活动范围。
平均随访 4.2 年和 5.3 年后，PFH 组和 IF 组的再撕裂率分别为 4%和 9%，并发症发生率分别为 1%和 2%。在 PFH 组中，年龄大于 23 岁的患者均无再撕裂。术后继发半月板损伤分别为 PFH 组和 IF 组的 6%和 9%。两组膝关节稳定性相似。PFH 组术后 6 个月的活动度明显更好，屈曲度为 136°。
对于 ACL 重建，压配混合®技术是一种新的替代方法。术后半月板继发损伤低，膝关节稳定性高，可预防后期膝关节骨关节炎。与干扰螺钉技术相比，在翻修手术中和年轻患者中使用压配混合®技术，再撕裂率降低的趋势令人鼓舞，需要进一步研究证实。
治疗性 III 级，回顾性队列研究。
