Runer Armin, Meena Amit, Jucho Lena, Wierer Guido, Csapo Robert, Abermann Elisabeth, Herbort Mirco, Hoser Christian, Fink Christian
Department for Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Gelenkpunkt - Sports and Joint Surgery, FIFA Medical Centre of Excellence, Innsbruck, Austria.
Arthroscopy. 2025 Jun;41(6):1961-1969. doi: 10.1016/j.arthro.2024.08.013. Epub 2024 Aug 28.
To compare patient-reported outcomes measurements and subsequent surgical interventions in patients treated with anterior cruciate ligament reconstruction (ACLR) using either quadriceps tendon autograft with a patellar bone block (bQT) or soft tissue only (sQT).
All ACLRs performed between January 2010 and March 2022 were prospectively followed for 24 months and retrospectively evaluated. All primary ACLRs with full 24 months of follow-up data, without any previous surgery or any additional ligamentous interventions, were matched for major ACL risk factors, including sex, age, Tegner activity level [TAL], pivoting sports, and concomitant injuries. Patient-reported outcomes measurements (Lysholm score, visual analog scale for pain, and TAL) and subsequent surgical interventions were registered after 6, 12, and 24 months postoperatively. Binary logistic regression was used to assess the influence of graft type, age, preinjury TAL, sex, pivoting sports, and concomitant interventions on the need to undergo subsequent surgery.
After matching, 246 patients were included in the final analysis. Both groups did not differ regarding any preoperative patient demographics or intraoperative details. At final follow-up, no significant differences in mean Lysholm score (sQT: 90.8 ± 10.6, bQT: 91.8 ± 10.6, P = .46), median TAL (sQT: 6 [1-10], bQT: 6 [1-10], P = .53), and visual analog scale for pain (sQT: 0.7 ± 1.1, bQT: 0.7 ± 1.2, P = .70) were reported between both groups. A total of 70.3% (sQT-A: 70.7%, bQT: 69.9%, P = .89) of patients returned to or exceeded their preinjury activity level. In terms of revision ACLR, there was no statistically significant difference between bQT (3.3%) and sQT (4.1%). Similarly, no difference was observed in contralateral ACLR (bQT: 7.3% sQT: 11.4%). Regression analysis indicated that none of the studied factors, including the use of a patellar bone block, influenced subsequent surgery, revision ACLR, or contralateral ACLR.
Harvesting an additional patellar bone block in quadriceps tendon ACLR does not seem to affect postoperative patient-reported outcomes, ACL revision, or contralateral ACL reconstruction rates.
Level III, cohort study.
比较使用带髌骨骨块的股四头肌肌腱自体移植物（bQT）或仅使用软组织自体移植物（sQT）进行前交叉韧带重建（ACLR）的患者报告的结局测量指标及随后的手术干预情况。
对2010年1月至2022年3月期间进行的所有ACLR手术患者进行前瞻性随访24个月，并进行回顾性评估。所有具有完整24个月随访数据、无既往手术史或任何额外韧带干预的初次ACLR患者，根据主要的ACL危险因素进行匹配，包括性别、年龄、Tegner活动水平（TAL）、旋转运动以及合并损伤情况。在术后6、12和24个月记录患者报告的结局测量指标（Lysholm评分、疼痛视觉模拟量表和TAL）以及随后的手术干预情况。采用二元逻辑回归分析评估移植物类型、年龄、伤前TAL、性别、旋转运动和合并干预对后续手术需求的影响。
匹配后，246例患者纳入最终分析。两组在任何术前患者人口统计学特征或术中细节方面均无差异。在最终随访时，两组间的平均Lysholm评分（sQT：90.8±10.6，bQT：91.8±10.6，P = 0.46）、中位TAL（sQT：6[1 - 10]，bQT：B[1 - 10]，P = 0.53）和疼痛视觉模拟量表评分（sQT：0.7±1.1，bQT：0.7±1.2，P = 0.70）均无显著差异。共有70.3%（sQT组：70.7%，bQT组：69.9%，P = 0.89）的患者恢复到或超过了伤前活动水平。在翻修ACLR方面，bQT组（3.3%）和sQT组（4.1%）之间无统计学显著差异。同样，在对侧ACLR方面也未观察到差异（bQT组：7.3%，sQT组：11.4%）。回归分析表明，包括使用髌骨骨块在内的所有研究因素均未影响后续手术、翻修ACLR或对侧ACLR。
在股四头肌肌腱ACLR中获取额外的髌骨骨块似乎不会影响术后患者报告的结局、ACLR翻修或对侧ACL重建率。
III级，队列研究。
