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当采用腘绳肌进行小直径同侧腘绳肌自体移植物增强时,对侧肢体的功能结局未见缺损。

No Deficits in Functional Outcomes of the Contralateral Limb Are Seen When the Hamstring Is Harvested for Augmentation of Small Diameter Ipsilateral Hamstring Autograft.

作者信息

Moran Thomas E, Ramamurti Pradip, Wells Douglas K, Thompson Xavier, Hart Joseph M, Diduch David R, Brockmeier Stephen F, Miller Mark D, Gwathmey Winston F, Werner Brian C

机构信息

Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.

出版信息

Arthrosc Sports Med Rehabil. 2023 Sep 21;5(5):100798. doi: 10.1016/j.asmr.2023.100798. eCollection 2023 Oct.

Abstract

PURPOSE

To evaluate clinical outcomes of the contralateral, nonoperative limb in patients undergoing contralateral hamstring (HS) autograft harvest compared with patients undergoing ipsilateral HS autograft harvest alone.

METHODS

This study included 96 patients who underwent isolated anterior cruciate ligament reconstruction (ACLR) using 4-stranded HS autograft (n = 85) or 4-stranded HS autograft augmented with contralateral HS (n = 13) due to inclusion of ipsilateral graft diameter <8 mm. Isokinetic flexion and extension strength and dynamic performance of the ipsilateral and contralateral limbs and limb symmetry index (LSI) were evaluated at 6 months' postoperatively. Rates of contralateral native ACL tear at minimum 2 years also were compared. For all comparisons, < .05 was considered statistically significant.

RESULTS

Normalized isokinetic knee flexion and extension strength of the contralateral limb did not differ between cohorts ( = .34;  = .21, respectively). LSI for knee extension peak torque and knee flexion peak torque did not differ between cohorts ( = .44;  = .67, respectively). No difference in LSI was seen for any dynamic performance testing (single leg hop,  = .97; triple leg hop,  = .14; 6-m timed hop,  = .99). No difference was observed in International Knee Documentation Committee ( = .99) or Knee Injury and Osteoarthritis Outcome Score subscale measures ( = .39-.86). No difference in rates of contralateral knee native ACL tears were seen between cohorts (HS autograft + contralateral HS augmentation, n = 2, 15.4%; HS autograft, n = 7, 8.4%;  = .26).

CONCLUSIONS

In this study, at the time of return to sport, we found no differences in contralateral limb functional performance or limb symmetry measurements between patients undergoing contralateral HS autograft harvest for augmentation of smaller (<8 mm) diameter HS autografts harvested from the injured extremity.

LEVEL OF EVIDENCE

Level III, retrospective cohort study.

摘要

目的

评估接受对侧自体腘绳肌(HS)移植的患者与仅接受同侧HS移植的患者相比,对侧非手术肢体的临床结局。

方法

本研究纳入96例接受孤立性前交叉韧带重建(ACLR)的患者,其中85例使用4股HS自体移植物,13例因同侧移植物直径<8 mm而使用对侧HS增强的4股HS自体移植物。术后6个月评估同侧和对侧肢体的等速屈伸力量、动态性能以及肢体对称指数(LSI)。还比较了至少2年时对侧天然前交叉韧带撕裂的发生率。对于所有比较,P<0.05被认为具有统计学意义。

结果

两组队列中对侧肢体的标准化等速膝关节屈伸力量无差异(分别为P = 0.34;P = 0.21)。两组队列中膝关节伸展峰值扭矩和膝关节屈曲峰值扭矩的LSI无差异(分别为P = 0.44;P = 0.67)。在任何动态性能测试中LSI均无差异(单腿跳,P = 0.97;双腿跳,P = 0.14;6米定时跳,P = 0.99)。国际膝关节文献委员会评分(P = 0.99)或膝关节损伤和骨关节炎结局评分子量表测量结果(P = 0.39 - 0.86)无差异。两组队列中对侧膝关节天然前交叉韧带撕裂的发生率无差异(HS自体移植物+对侧HS增强,n = 2,15.4%;HS自体移植物,n = 7,8.4%;P = 0.26)。

结论

在本研究中,在恢复运动时,我们发现接受对侧HS移植以增强从受伤肢体获取的较小(<8 mm)直径HS自体移植物的患者与未接受对侧HS移植的患者相比,对侧肢体功能性能或肢体对称测量结果无差异。

证据水平

III级,回顾性队列研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e99/10523181/babdb6288933/gr1.jpg

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