Daniel Adam V, Smith Patrick A
Columbia Orthopaedic Group, Columbia, Missouri, U.S.A..
Columbia Orthopaedic Group, Columbia, Missouri, U.S.A.
Arthroscopy. 2025 Jan;41(1):95-105. doi: 10.1016/j.arthro.2024.02.047. Epub 2024 Mar 20.
To evaluate ≥2-year patient outcomes after primary all-soft tissue quadriceps tendon autograft (ASTQ) anterior cruciate ligament reconstruction (ACLR) with suture tape augmentation (STA) in skeletally mature high school and collegiate athletes.
All high school and collegiate athletes who underwent primary ASTQ ACLR with STA with a minimum of 2-year follow-up were analyzed retrospectively. Patients were administered validated patient-reported outcome measures (PROMs) pre- and postoperatively. The minimal clinically important difference was calculated for each PROM based on this study population and applied to the individual patient. Return to sport, subsequent surgical intervention including contralateral ACLR, and KT-1000 arthrometer measurements for knee laxity were collected. Complications were assessed by physical examination, radiologic studies, or obtained via telephone.
In total, 60 patients were included in the final data analysis, with a mean age of 16.8 years (95% confidence interval 13-23) and mean final follow-up of 37.1 months (95% confidence interval 33.1-41.1). Twelve patients (20%) required subsequent surgery on the ipsilateral knee, which included 7 patients having a subsequent meniscal procedure and 3 patients who underwent arthrolysis. None sustained a graft failure, and 6 patients sustained a contralateral ACL injury necessitating surgery. All PROMs improved at the final follow-up (P < .001). In addition, KT-1000 arthrometer measurements significantly improved postoperatively at 1-year clinical follow-up (P < .001). Most patients obtained the minimal clinically important difference thresholds for each PROM at the final follow-up. There were 48 patients (80%) who participated in pivoting sports. The return-to-sport rate at same level was 54 patients (90%), with 6 patients (10%) not returning to the same level because of graduation.
ASTQ ACLR with STA in a young athletic patient population may result in a low graft failure rate while maintaining satisfactory patient outcomes at short-term follow-up, including a return to sport at the same level of 90%.
Level IV, retrospective case series.
评估在骨骼成熟的高中和大学运动员中，采用缝线带增强技术（STA）的原发性全软组织股四头肌肌腱自体移植（ASTQ）前交叉韧带重建（ACLR）术后≥2年的患者预后。
对所有接受原发性ASTQ ACLR并采用STA且至少随访2年的高中和大学运动员进行回顾性分析。患者在术前和术后接受经过验证的患者报告结局测量（PROMs）。根据该研究人群计算每个PROM的最小临床重要差异，并应用于个体患者。收集恢复运动情况、包括对侧ACLR在内的后续手术干预以及用于评估膝关节松弛度的KT-1000关节测量仪测量结果。通过体格检查、影像学研究或电话随访评估并发症情况。
最终数据分析共纳入60例患者，平均年龄16.8岁（95%置信区间13 - 23岁），平均末次随访时间37.1个月（95%置信区间33.1 - 41.1个月）。12例患者（20%）需要对同侧膝关节进行后续手术，其中7例患者进行了后续半月板手术，3例患者接受了关节松解术。无一例发生移植物失败，6例患者发生对侧ACL损伤并需要手术治疗。所有PROMs在末次随访时均有改善（P < .001）。此外，KT-1000关节测量仪测量结果在术后1年临床随访时显著改善（P < .001）。大多数患者在末次随访时达到了每个PROM的最小临床重要差异阈值。有48例患者（80%）参与了旋转运动。同水平恢复运动率为54例患者（90%），6例患者（10%）因毕业未恢复到同水平。
在年轻运动员人群中，采用STA的ASTQ ACLR可能导致较低的移植物失败率，同时在短期随访中保持令人满意的患者预后，包括90%的同水平恢复运动率。
IV级，回顾性病例系列。
