Sydney Orthopaedic Research Institute, Sydney, New South Wales, Australia.
Charles Darwin University, Darwin, Northern Territory, Australia.
Knee Surg Sports Traumatol Arthrosc. 2024 Nov;32(11):2885-2894. doi: 10.1002/ksa.12310. Epub 2024 Jun 11.
The study hypothesized that the addition of lateral extra-articular tenodesis (LEAT) in anterior cruciate ligament reconstruction (ACLR) had a significant effect on ACL graft healing.
A total of 80 patients were divided into two cohorts matched for gender, age, body mass index, time from surgery to post-operative MRI and graft diameter. Forty patients underwent ACL reconstruction alone, while 40 underwent ACLR in addition to LEAT. Patients underwent a magnetic resonance imaging scan at 12 months post-surgery; tunnel apertures were measured using multiplanar reformation, graft healing was assessed using signal-to-noise quotient (SNQ) in three regions of interest and finally graft maturity and integration were classified using the Howell and Ge scale, respectively. In addition, clinical evaluation and patient-reported outcome measures were collected.
The mean femoral tunnel widening at 12 months post-surgery was 39.8 ± 14.0% in the ACLR + LEAT group and 55.2 ± 12.7% in the ACLR alone group (p < 0.05). The mean tibial tunnel widening was 29.3 ± 12.7% in the ACLR + LEAT group and 44.4 ± 12.1% in the ACLR group (p < 0.05). The mean adjusted graft SNQ was 9.0 ± 14.9 in the ACLR + LEAT group and 9.5 ± 11.4 in the ACLR group (n.s.).
At 1 year post-operatively, we noted significantly less femoral and tibial tunnel widening in the ACLR + LEAT group. LEAT did not result in a statistically significant effect on graft healing.
Level III.
本研究假设在前交叉韧带重建 (ACLR) 中增加外侧关节外固定术 (LEAT) 对 ACL 移植物愈合有显著影响。
共 80 例患者分为两组，两组在性别、年龄、体重指数、手术至术后 MRI 时间和移植物直径方面匹配。40 例患者仅行 ACLR，40 例患者行 ACLR 联合 LEAT。患者在术后 12 个月行磁共振成像扫描；使用多平面重建测量隧道开口，使用信号噪声比 (SNQ) 在三个感兴趣区域评估移植物愈合情况，最后使用 Howell 和 Ge 量表分别对移植物成熟度和整合度进行分类。此外，还收集了临床评估和患者报告的结果测量。
在 ACLR+LEAT 组中，术后 12 个月股骨隧道增宽率为 39.8±14.0%，在 ACLR 组中为 55.2±12.7%（p<0.05）。在 ACLR+LEAT 组中，胫骨隧道增宽率为 29.3±12.7%，在 ACLR 组中为 44.4±12.1%（p<0.05）。ACL+LEAT 组的平均调整后的移植物 SNQ 为 9.0±14.9，ACL 组为 9.5±11.4（无统计学意义）。
术后 1 年，我们发现 ACLR+LEAT 组股骨和胫骨隧道的增宽明显减少。LEAT 对移植物愈合没有统计学上的显著影响。
III 级。
