Nabil Ahmed, Abd Halim Hafez Khaled, Rizk Ahmed, Abu Taleb Ahmed, Emad Ramy
Orthopaedic Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Orthop. 2024 Feb 10;53:7-12. doi: 10.1016/j.jor.2024.02.015. eCollection 2024 Jul.
The purpose of this randomised controlled trial was to assess the effect on knee function and stabilising effectiveness of lateral extra-articular tenodesis (LET) in anterior cruciate ligament (ACL) restoration.
A prospective randomised clinical study that compared the functional outcomes of two groups-one undergoing anatomic single bundle ACL reconstruction (ASB-ACLR) with ilio-tibial band tenodesis (LET) for 20 patients, and the other undergoing ASB-ACLR-was carried out between February 2020 and August 2022.
By combining Lateral Extra-articular Tenodesis (LET) with intra-articular Anterior Cruciate Ligament Reconstruction (ACLR), our study observed a significant reduction in the occurrence of high-grade pivot-shift phenomena. Prior to surgery, both Groups A and B exhibited graded (D) pivot-shift test results. However, post-surgery, the pivot-shift test yielded negative results in 60% of patients in Group A and 90% of patients in Group B. The statistical analysis revealed a notable difference between the two groups, as indicated by a P-value of 0.003. Upon conducting a brief follow-up, we evaluated the Lysholm score, and anterior knee stability of ACLR with LET, finding no statistically significant difference compared to those of single ACLR. The Lachman tests also revealed no significant disparity between the two groups (p = 0.106). Analyzing the Lysholm scores in Group A and Group B, we observed an increase to 90.70% and 91.10%, respectively.
Rotational stability is much improved when lateral extra-articular tenodesis (LET) utilizing the ilio-tibial band as an augmentation is used in ACL restoration. Especially useful for high-grade pivot-shift phenomena is this technique.
本随机对照试验旨在评估外侧关节外肌腱固定术（LET）在前交叉韧带（ACL）重建中对膝关节功能和稳定效果的影响。
一项前瞻性随机临床研究比较了两组的功能结果。一组为20例患者接受解剖单束ACL重建（ASB-ACLR）并联合髂胫束肌腱固定术（LET），另一组接受ASB-ACLR。该研究于2020年2月至2022年8月进行。
通过将外侧关节外肌腱固定术（LET）与关节内前交叉韧带重建（ACLR）相结合，我们的研究观察到高级别旋转推移现象的发生率显著降低。术前，A组和B组均表现出分级（D）旋转推移试验结果。然而，术后，A组60%的患者和B组90%的患者旋转推移试验结果为阴性。统计分析显示两组之间存在显著差异，P值为0.003。在进行简短随访时，我们评估了接受LET的ACLR的Lysholm评分和膝关节前侧稳定性，发现与单纯ACLR相比无统计学显著差异。Lachman试验也显示两组之间无显著差异（p = 0.106）。分析A组和B组的Lysholm评分，我们观察到分别提高到了90.70%和91.10%。
在ACL重建中使用以髂胫束作为增强的外侧关节外肌腱固定术（LET）时，旋转稳定性有很大改善。该技术对高级别旋转推移现象特别有用。
