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使用股四头肌中央肌腱移植物进行关节镜下前交叉韧带重建的功能结果分析

Analysis of the Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Using the Central Quadriceps Tendon Graft.

作者信息

Parameshwar Ambareesh, Kumar Lanka Bhupati, Donthi Supreeth R, Gurucharan S, Reddy Nishanth J, Gbs Varun, M S Vishwanath, Gurudatta Amruta, Shahid Mohammed

机构信息

Trauma and Orthopedics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.

College of Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.

出版信息

Cureus. 2024 Jul 25;16(7):e65351. doi: 10.7759/cureus.65351. eCollection 2024 Jul.

Abstract

INTRODUCTION

Anterior cruciate ligament (ACL) injuries are common, particularly among athletes, and often result in knee instability and decreased functionality. Arthroscopic ACL reconstruction is the standard treatment, typically using a patellar tendon bone graft (PTBG) or hamstring tendon graft (HTG). The central quadriceps tendon graft (QTG) has been proposed as a superior alternative due to its structural properties.

METHODOLOGY

This study involved patients undergoing ACL reconstruction using the central quadriceps tendon graft. Functional outcomes were assessed using the Tegner Lysholm knee score were assessed at preoperative and postoperative intervals of two weeks, three months, and six months. Statistical analysis compared these scores over time.

RESULTS

Among the subjects, 90.6% were male and 9.4% were female. Injuries primarily resulted from sports activities and road traffic accidents (46.9% each). Right-side injuries were more prevalent (65.6%). The mean time from injury to surgery was 9.37 months. The mean graft size was 8.75 mm, and the mean tourniquet time was 105.94 minutes. Preoperative tests showed positive results for anterior drawer, Lachman, and pivot shift tests in most patients, which were negative postoperatively. Significant improvements in knee flexion and Lysholm knee scores were observed. Preoperative knee flexion ranged from 0-100° to 0-120°, improving to 0-120° to 0-130° six months postoperatively. The mean Lysholm knee score improved from 47.06 preoperatively to 93.16 at six months. Excellent outcomes were seen in 78.1% of the patients, with 21.9% achieving good outcomes.

CONCLUSION

The central quadriceps tendon graft is an effective option for ACL reconstruction, offering excellent functional outcomes and low complication rates. It shows promise as a better alternative to traditional graft types, although further research is necessary to confirm these findings.

摘要

引言

前交叉韧带(ACL)损伤很常见,尤其是在运动员中,并且常常导致膝关节不稳定和功能下降。关节镜下ACL重建是标准治疗方法,通常使用髌腱骨移植(PTBG)或腘绳肌腱移植(HTG)。中央股四头肌腱移植(QTG)因其结构特性已被提议作为一种更好的替代方法。

方法

本研究纳入了接受中央股四头肌腱移植进行ACL重建的患者。使用Tegner Lysholm膝关节评分在术前以及术后两周、三个月和六个月时评估功能结果。统计分析比较了这些评分随时间的变化。

结果

在这些受试者中,90.6%为男性,9.4%为女性。损伤主要由体育活动和道路交通事故导致(各占46.9%)。右侧损伤更为常见(65.6%)。从受伤到手术的平均时间为9.37个月。移植肌腱的平均尺寸为8.75毫米,平均止血带时间为105.94分钟。术前检查显示大多数患者前抽屉试验、拉赫曼试验和轴移试验结果为阳性,术后均为阴性。观察到膝关节屈曲和Lysholm膝关节评分有显著改善。术前膝关节屈曲范围为0 - 100°至0 - 120°,术后六个月改善至0 - 120°至0 - 130°。Lysholm膝关节评分的平均值从术前的47.06提高到六个月时的93.16。78.1%的患者获得了优异的结果,21.9%的患者获得了良好的结果。

结论

中央股四头肌腱移植是ACL重建的一种有效选择,具有优异的功能结果和低并发症发生率。它显示出作为传统移植类型更好替代方法的潜力,尽管需要进一步研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/11344487/2fc03791be35/cureus-0016-00000065351-i01.jpg

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