Bora Manu, Deshmukh Prithviraj
Orthopedic Surgery, Nexus Day Surgery Center, Mumbai, IND.
Cureus. 2023 Sep 5;15(9):e44700. doi: 10.7759/cureus.44700. eCollection 2023 Sep.
The purpose of this study is to report the early one-year clinical and patient-reported functional outcomes of semitendinosus autograft anterior cruciate ligament reconstruction with the FiberTape® InternalBrace™ all-inside technique.
The patient-reported functional outcomes and clinical outcomes were analyzed prospectively following the treatment of 324 unilateral ACL rupture cases with the FiberTape® InternalBrace™ Technique. Patient-reported outcome measures (KOOS scores, WOMAC scores, VAS score, and IKDC score) and clinical examinations like pre-operative and post-operative pivot shift, Lachman test, and range of motion (ROM) were conducted. These tests and examinations were recorded for each patient before surgery and at 3, 6, and 12 months after surgery. Secondary outcomes like re-rupture, infection, synovitis, or limited range of motion were noted. The mean follow-up period was 18±4.5 months (range: 12-24 months).
Out of a total of 324 cases, 37 cases (11.4%) could not be followed up. 158 patients (55.1%) were male and 129 were female (44.9%). Preoperative mean KOOS pain value, KOOS symptoms, KOOS ADLs, KOOS sport and recreation, and KOOS quality of life were 77.05, 78.69, 84, 21, 89.7, and 57, respectively. All KOOS subsections increased significantly at one-year to 98.37, 99.09, 98.95, 99.02, and 99.30 (p<0.0001), respectively. Mean preoperative WOMAC pain, WOMAC stiffness, and WOMAC function were 76.4, 65.2, and 74.1 and increased significantly at one-year to 94.5, 89.6, and 98.2 (p<0.0001), respectively. There was a significant decrease in VAS for pain from 2.93 before surgery to 0.12 (p<0.0001) at one year. The IKDC score significantly changed from a pre-treatment value of 50.9 to 96.2 (94.5-97.8) at a follow-up of one year. The Lysholm score at 12-months was significant at 95 (93.1-96.9), p<0.05. Post-operative Lachman test values decreased significantly, which meant decreased laxity, from 1.98 (1.89-2.07) pre-operative to 1.60 (1.57-1.62) p<0.05 at one-year post-operative. At one-year follow-up, 276 patients (96%) had fully recovered.
It was concluded that the FiberTape® InternalBrace™ technique for ACL reconstruction provides orthopedic surgeons with an effective alternative technique to conventional methods of surgery and also reduces the overall time to recovery for patients, thereby allowing them to return to sports faster.
Level 4.
本研究旨在报告采用FiberTape® InternalBrace™全内置技术进行半腱肌自体移植前交叉韧带重建的早期一年临床及患者报告的功能结果。
对324例单侧前交叉韧带断裂病例采用FiberTape® InternalBrace™技术治疗后，前瞻性分析患者报告的功能结果和临床结果。进行患者报告的结局指标（膝关节损伤和骨关节炎疗效评分（KOOS）、西部安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟评分（VAS）和国际膝关节文献委员会（IKDC）评分）以及临床检查，如术前和术后的轴移试验、拉赫曼试验和活动范围（ROM）。这些检查在每位患者手术前以及术后3、6和12个月进行记录。记录二次结局，如再断裂、感染、滑膜炎或活动范围受限情况。平均随访期为18±4.5个月（范围：12 - 24个月）。
在总共324例病例中，37例（11.4%）无法进行随访。158例患者（55.1%）为男性，129例为女性（44.9%）。术前平均KOOS疼痛值、KOOS症状、KOOS日常生活活动、KOOS运动与娱乐以及KOOS生活质量分别为77.05、78.69、84、21、89.7和57。所有KOOS子项在一年时均显著增加，分别达到98.37、99.09、98.95、99.02和99.30（p<0.0001）。术前平均WOMAC疼痛、WOMAC僵硬和WOMAC功能分别为76.4、65.2和74.1，在一年时显著增加至94.5、89.6和98.2（p<0.0001）。疼痛的VAS从术前的2.93显著降至一年时的0.12（p<0.0001）。IKDC评分在一年随访时从治疗前的50.9显著变为96.2（94.5 - 97.8）。12个月时的Lysholm评分为95（93.1 - 96.9），具有统计学意义，p<0.05。术后拉赫曼试验值显著降低，这意味着松弛度降低，从术前的1.98（1.89 - 2.07）降至术后一年的1.60（1.57 - 1.62），p<0.05。在一年随访时，276例患者（96%）已完全康复。
得出结论，FiberTape® InternalBrace™技术用于前交叉韧带重建为骨科医生提供了一种有效的替代传统手术方法的技术，同时也减少了患者的总体恢复时间，从而使他们能够更快地恢复运动。
4级。
