Department of Orthopaedics and Traumatology, Haseki Education and Training Hospital, Istanbul, Turkey.
Department of Orthopaedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
J Knee Surg. 2024 Oct;37(12):843-850. doi: 10.1055/s-0044-1787829. Epub 2024 Jun 19.
The aim of our study is to evaluate preserving gracilis tendon in anterior cruciate ligament reconstruction (ACLR) surgery and its effect to the flexion of the knee joint and tibial internal rotation strength and the stability of the knee. Patients who underwent primary single-bundle arthroscopic ACLR using all-inside technique and using hamstring tendon autograft were evaluated retrospectively. Patients were divided into two groups as gracilis preserved (St) and gracilis harvested (StG) groups. The International Knee Documentation Committee (IKDC) score, Lysholm, Knee Injury and Osteoarthritis Outcome Score-Knee-related quality of life (KOOS-QOL) score, ACL-Return to Sport after Injury scale score were used to evaluate as postoperative functional scores at last follow-up. Anterior tibial translation was evaluated using the KT-1000 device. Knee joint flexion, extension, and internal rotation strength were evaluated using isokinetic dynamometer. Dynamic balance performances were measured using the Biodex Balance System. There were 24 patients in the St group and 23 patients in the StG group. Demographic data and clinical results showed no significant difference. Anteroposterior movement of the tibia was found to be significantly higher in the StG group than in the St group in measurements at 89 and 134 N, respectively ( = 0.01 and <0.001). No statistically significant difference was found between both standard and deep flexor and extensor and internal rotator strength. No statistically significant difference was found in the amount of total, anteroposterior, and mediolateral balance deficit between the two groups. Additional gracilis harvesting does not have a negative effect on both standard and deep knee flexion, and tibial internal rotation strength compared with the St group. Although semitendinosus and StG group showed significantly more anterior tibial translation, there was no significant difference in clinical and dynamic stability measurements.
我们的研究目的是评估在前交叉韧带重建 (ACLR) 手术中保留股薄肌腱及其对膝关节屈曲、胫骨内旋力量和膝关节稳定性的影响。回顾性评估了接受全内技术和使用自体腘绳肌腱进行初次单束关节镜 ACLR 的患者。患者分为保留股薄肌 (St) 组和股薄肌采集 (StG) 组。术后功能评分采用国际膝关节文献委员会 (IKDC) 评分、Lysholm、膝关节损伤和骨关节炎结局评分-膝关节相关生活质量 (KOOS-QOL) 评分、ACL 损伤后重返运动评分进行评估。使用 KT-1000 设备评估胫骨前移位。使用等速测力计评估膝关节屈曲、伸展和内旋力量。使用 Biodex 平衡系统测量动态平衡表现。St 组有 24 例，StG 组有 23 例。两组患者的人口统计学数据和临床结果无显著差异。在 89N 和 134N 测量时，StG 组胫骨前移位明显高于 St 组（ = 0.01 和 <0.001）。两组标准和深层屈肌和伸肌以及内旋肌力量无统计学差异。两组间总、前后和内外平衡缺陷量无统计学差异。与 St 组相比，额外采集股薄肌不会对标准和深层膝关节屈曲以及胫骨内旋力量产生负面影响。尽管半腱肌和 StG 组的胫骨前移位明显较多，但在临床和动态稳定性测量方面无显著差异。
