Ciancio Bruno Aspirino, Azuma Marina Mayumi, Cerqueira João Victor Medeiros De, Miyashita Gustavo Kenzo, Yamashita Jorge Liozi, Ramos Leonardo Addêo
Hospital Nipo Brasileiro, São Paulo, SP, Brasil.
Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Sep 4;59(4):e542-e548. doi: 10.1055/s-0043-1770970. eCollection 2024 Aug.
The purpose of this study was to evaluate the clinical and functional results of simultaneous reconstruction of the ACL and PCL with bilateral hamstring autografts. We hypothesized that this reconstruction technique results in less morbidity and has similar results to the ones published in the previous literature. Eighteen patients with bicruciate lesions were selected and treated by arthroscopic surgery with autologous hamstring tendons in a single-stage procedure. The thicker semitendinosus tendon (ST) and the two gracilis tendons (G) were used for a 6-strand PCL reconstruction. The thinner ST was used for a 3-strand ACL reconstruction. The average patient age at surgery was 31 years, and the minimum follow-up was 2 years. Function of the operated knee was evaluated according to the Lysholm scale. Anterior knee laxity was examined with a KT-1000 arthrometer. Posterior laxity was evaluated using stress radiographies. Statistically significant improvements were found for all three measurements ( < 0.001). Knee function by the Lysholm score increased from 43.8 ± 4.1 to 89.9 ± 3.8 post-surgery. The average anterior knee laxity improved from 5.2 + -0.8 mm initially to 2.4 + - 0.5 mm post-surgery. The posterior translation of the tibia relative to the femur decreased from 10 ± 3.4 mm to 3 ± 1.6 mm post-surgery. No patient showed loss of motion in extension or knee flexion. The simultaneous bicruciate reconstruction with bilateral hamstring autograft is a valuable option to achieve good functional outcomes and ligamentous stability.
本研究的目的是评估采用双侧自体腘绳肌腱同时重建前交叉韧带(ACL)和后交叉韧带(PCL)的临床和功能结果。我们假设这种重建技术导致的发病率较低,并且与先前文献中发表的结果相似。 选择18例双十字韧带损伤患者,采用关节镜手术单阶段自体腘绳肌腱治疗。较粗的半腱肌腱(ST)和两条股薄肌腱(G)用于6股PCL重建。较细的ST用于3股ACL重建。手术时患者的平均年龄为31岁,最短随访时间为2年。根据Lysholm量表评估手术膝关节的功能。使用KT-1000关节测量仪检查膝关节前向松弛度。使用应力X线片评估后向松弛度。 所有三项测量均发现有统计学意义的改善(<0.001)。Lysholm评分的膝关节功能从术前的43.8±4.1提高到术后的89.9±3.8。膝关节前向平均松弛度从最初的5.2±0.8mm改善到术后的2.4±0.5mm。胫骨相对于股骨的后向平移从术前的10±3.4mm降至术后的3±1.6mm。没有患者出现伸直或膝关节屈曲活动度丧失。 采用双侧自体腘绳肌腱同时进行双十字韧带重建是实现良好功能结果和韧带稳定性的一种有价值的选择。