Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, 1157637131, Iran.
Shafa Orthopedic Hospital, Baharestan Square, Mojahedin-e-Islam St, Shafa Yahyaian Educational and Medical Center, Iran University of Medical Science, Tehran, 1157637131, Iran.
Eur J Orthop Surg Traumatol. 2023 Jul;33(5):2049-2055. doi: 10.1007/s00590-022-03390-0. Epub 2022 Sep 20.
The outcomes of anterior cruciate ligament reconstruction (ACLR) in patients with generalized joint laxity (GJL) are not clearly understood. In this study, we compared the outcomes of ACLR with quadruple hamstring autograft between GJL and non-GJL patients.
In a retrospective case-control study, 36 patients with GJL, according to the Beighton and Horan Joint Mobility Index, who underwent ACLR surgery, were included. Forty-four group-matched non-GJL patients were included in the control group. The mean follow-up of the patients was 20.65 ± 6.93 months. The outcomes of ACLR were evaluated by the Lachman test, pivot shift test, anterior tibial translation and KT-1000 side-to-side difference, and International Knee Documentation Committee (IKDC) scale.
The results of the Lachman and pivot shift test were not significantly different between the GJL and non-GJL patients (P = 0.67 and P = 0.27, respectively). The mean anterior tibial translation was 7.06 ± 1.41 mm in the GJL group and 6.11 ± 1.53 mm in the non-GJL group (P = 0.006). The mean KT-1000 side-to-side difference was 2.25 ± 1.31 mm in the case and 2.5 ± 1.44 mm in the control group (P = 0.42). The mean IKDC score of the patients was not significantly different between the GJL and non-GJL groups (66.1 ± 20.6 vs. 69.9 ± 16.1, P = 0.35). ACLR failure occurred in 2 (5.5%) patients of the GJL group and no patients of the control group (P = 0.21).
The present findings suggest ACLR with quadruple hamstring autograft as an adequate treatment for GJL patients, at least in short-term follow-up.
患有全身性关节松弛症(GJL)的患者前交叉韧带重建(ACLR)的结果尚不清楚。在这项研究中,我们比较了 GJL 和非 GJL 患者 ACLR 与四股腘绳肌腱自体移植的结果。
在回顾性病例对照研究中,根据 Beighton 和 Horan 关节活动度指数,纳入 36 例 GJL 并接受 ACLR 手术的患者。在对照组中纳入 44 例匹配的非 GJL 患者。患者的平均随访时间为 20.65±6.93 个月。通过 Lachman 试验、前抽屉试验、胫骨前移和 KT-1000 侧移差值以及国际膝关节文献委员会(IKDC)评分评估 ACLR 的结果。
GJL 和非 GJL 患者的 Lachman 和前抽屉试验结果无显著差异(P=0.67 和 P=0.27)。GJL 组胫骨前移的平均距离为 7.06±1.41mm,非 GJL 组为 6.11±1.53mm(P=0.006)。病例组的平均 KT-1000 侧移差值为 2.25±1.31mm,对照组为 2.5±1.44mm(P=0.42)。GJL 和非 GJL 组患者的 IKDC 评分无显著差异(66.1±20.6 vs. 69.9±16.1,P=0.35)。GJL 组有 2 例(5.5%)患者发生 ACLR 失败,而对照组无患者(P=0.21)。
本研究结果表明,对于 GJL 患者,四股腘绳肌腱自体移植的 ACLR 是一种有效的治疗方法,至少在短期随访中是这样。