Endreß Frank, Hörner Reinhard, Hauth Wolfgang, Anders Jens, Biber Roland
Kliniken Dr. Erler gGmbH, Kontumazgarten 4-19, 90429 Nürnberg, Germany.
Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Schloßplatz 4, 91054 Erlangen, Germany.
J Pers Med. 2023 Jun 21;13(7):1022. doi: 10.3390/jpm13071022.
Both dynamic intraligamentary stabilization (DIS) and reconstruction (RECO) are common treatment methods for anterior cruciate ligament (ACL) rupture. We report short term outcomes after DIS (Ligamys, Mathys, Bettlach, Switzerland) and RECO using semitendinosus tendon. We compared postoperative complications, deficits of range-of-motion (ROM), and revision rates between the two treatment options.
A total of 690 patients (437 male, 253 female), after either DIS or RECO, were included. Of these, 147 patients (21%) received DIS and 543 (79%) underwent RECO. Follow-up examination focused on clinical examination, complications and revision rates. Anteroposterior instability and ROM deficits were analyzed in order to evaluate our policy of early intervention for all cases of ROM restrictions.
Relevant ROM restrictions occurred at a significantly higher rate after DIS than after RECO (4.8% vs. 1.3%; = 0.008). Flexion was more restricted after DIS than RECO (110° vs. 124°, < 0.001). Extension deficits also occurred more frequently after DIS compared to RECO (49.7% vs. 24.5%; < 0.001). Total revision surgery rate was 9.1%, with patients after DIS being significantly more frequently affected (20.4% vs. 6.1%; < 0.001).
Our findings indicate a significantly higher risk for ROM restriction after DIS compared to RECO, resulting in a significantly higher revision rate.
动态韧带内稳定术（DIS）和重建术（RECO）都是治疗前交叉韧带（ACL）断裂的常用方法。我们报告了使用Ligamys（瑞士马蒂斯公司，贝特拉克）进行DIS以及使用半腱肌腱进行RECO后的短期疗效。我们比较了两种治疗方法术后的并发症、活动范围（ROM）受限情况及翻修率。
共纳入690例接受DIS或RECO治疗的患者（男性437例，女性253例）。其中，147例（21%）接受了DIS，543例（79%）接受了RECO。随访检查重点关注临床检查、并发症及翻修率。分析前后向不稳定和ROM受限情况，以评估我们对所有ROM受限病例进行早期干预的策略。
DIS后出现相关ROM受限的发生率显著高于RECO（4.8%对1.3%；P = 0.008）。DIS后的屈曲受限比RECO更明显（110°对124°，P < 0.001）。与RECO相比，DIS后伸直受限也更频繁出现（49.7%对24.5%；P < 0.001）。总翻修手术率为9.1%，DIS后的患者受影响的频率显著更高（20.4%对6.1%；P < 0.001）。
我们的研究结果表明，与RECO相比，DIS后ROM受限的风险显著更高，导致翻修率显著更高。
