Chandru Vijay, M S Santhosh, J S Sujana Theja, Nair Rohit R
Orthopaedics and Traumatology, Jagadguru Sri Shivarathreeshwara Hospital, Jagadguru Sri Shivarathreeshwara Academy of Higher Education and Research, Mysuru, IND.
Cureus. 2022 Apr 17;14(4):e24218. doi: 10.7759/cureus.24218. eCollection 2022 Apr.
Introduction With the advent of fixed- and variable-loop suspensory fixation devices for arthroscopic anterior cruciate ligament (ACL) reconstruction, a maximum number of grafts can be placed within the femoral tunnel. Although several biomechanical studies have been conducted comparing these two devices, only a few comparative clinical studies are available. This study was conducted to compare the functional outcomes of arthroscopic ACL reconstruction using fixed-loop devices with those of variable-loop devices by determining their effect on graft laxity clinical assessment and patient-reported outcome scores. Methodology Out of 32 patients (27 males and five females) who underwent primary ACL reconstruction using tripled hamstring autograft, fixed- and variable-loop devices were used for 13 and 19 patients, respectively. Thirteen patients in each group were evaluated over a period of one year using the Lysholm knee score. Six patients in the variable-loop group had only six months of follow-up. Anterior drawer and Lachman tests were performed at six-month and one-year follow-ups, respectively. Results The mean ages of patients in the fixed- and variable-loop groups were 34.5[Formula: see text]11 and 34.1[Formula: see text]9.1 years, respectively. The Lysholm knee score at six weeks was fair in 7.7% of the patients in the fixed-loop group when compared to 52.6% of those in the variable-loop group (<0.05). All the other parameters were comparable between the two groups. One patient in each group had ligament laxity at six-month and one-year follow-up, respectively. Conclusion This study showed no statistically significant difference in graft laxity or functional outcomes of arthroscopic ACL reconstruction with fixed- and variable-loop devices, except for a better patient-reported outcome score in the variable-loop group at six weeks of follow-up. Hence, there is a need for more comparative studies in this direction.
引言 随着用于关节镜下前交叉韧带（ACL）重建的固定环和可变环悬吊固定装置的出现，股骨隧道内可放置的移植物数量达到了最大值。尽管已经进行了多项生物力学研究来比较这两种装置，但仅有少数比较性临床研究。本研究旨在通过确定固定环装置和可变环装置对移植物松弛度临床评估和患者报告的结果评分的影响，比较使用固定环装置与可变环装置进行关节镜下ACL重建的功能结果。方法 在32例（27例男性和5例女性）接受自体腘绳肌肌腱三联移植进行初次ACL重建的患者中，分别有13例和19例患者使用了固定环装置和可变环装置。每组13例患者使用Lysholm膝关节评分进行了为期一年的评估。可变环组的6例患者仅随访了6个月。分别在6个月和1年随访时进行前抽屉试验和Lachman试验。结果 固定环组和可变环组患者的平均年龄分别为34.5±11岁和34.1±9.1岁。固定环组7.7%的患者在6周时Lysholm膝关节评分为中等，而可变环组为52.6%（<0.05）。两组之间的所有其他参数具有可比性。每组各有1例患者在6个月和1年随访时出现韧带松弛。结论 本研究表明，除了可变环组在随访6周时患者报告的结果评分更好外，使用固定环装置和可变环装置进行关节镜下ACL重建在移植物松弛度或功能结果方面没有统计学上的显著差异。因此，需要在这个方向上进行更多的比较研究。
