Khan Mohammed Inayathulla, Ismail Inas, Shetty Savith, Jebbar Jithin A, Faiaz Afra, Mohammed Shameez, Shetty Abhishek V, Ahammed Imthiaz, Shahid Mohammed
Orthopedics, Yenepoya Medical College and Hospital, Mangalore, IND.
Anesthesiology, Kanachur Institute of Medical Sciences, Mangalore, IND.
Cureus. 2024 Aug 15;16(8):e66945. doi: 10.7759/cureus.66945. eCollection 2024 Aug.
Introduction Anterior cruciate ligament reconstruction (ACLR) with autografts has been available for decades; however, the choice of graft is still debated. Here, we compared the functional outcomes of the two most widely used autografts, bone-patella tendon-bone (BPTB) and quadruple-stranded semitendinosus/gracilis (ST/G) autografts, at six months following ACLR. Materials and methods This prospective study was performed in the Department of Orthopedics of Yenepoya Medical College and Hospital located in Mangalore, Karnataka, India, a tertiary care institute over a period of 18 months (November 2018 to April 2020). The study included 38 adult patients who underwent ACLR and were randomly divided into two groups: BPTB autograft (n=19) or ST/G autograft (N=19). The patients were followed up at one-, three-, and six months. Postoperatively, surgical morbidity, knee stability functional outcome on Lysholm score, and knee range of motion (ROM) were assessed. Results The groups were homogenous and comparable regarding age, sex, side of ACL affected, duration of tear to treatment, and muscle wasting (all p-values > 0.05). At six months, the majority of the patients had a tibial translation of 0-2 mm on the Lachman test and anterior drawer test, and the groups did not differ significantly (both p-values > 0.05). Additionally, at six months, both groups demonstrated a significant increase in mean Lysholm score and mean ROM (both p-values < 0.001). However, the groups did not differ in mean Lysholm score and mean ROM at baseline and any of the follow-up visits (all p-values > 0.05). Conclusion At six months, ACLR with BPTB and ST/G autografts produced significant and comparable knee stability, functional outcome, and ROM.
引言 自体移植进行前交叉韧带重建(ACLR)已有数十年历史;然而,移植物的选择仍存在争议。在此,我们比较了ACLR术后六个月时两种最常用的自体移植物,即骨-髌腱-骨(BPTB)和四股半腱肌/股薄肌(ST/G)自体移植物的功能结果。
材料与方法 本前瞻性研究在印度卡纳塔克邦芒格洛尔的Yenepoya医学院和医院骨科进行,该机构为三级医疗机构,研究为期18个月(2018年11月至2020年4月)。研究纳入38例接受ACLR的成年患者,随机分为两组:BPTB自体移植物组(n = 19)或ST/G自体移植物组(N = 19)。在1个月、3个月和6个月时对患者进行随访。术后评估手术并发症、Lysholm评分的膝关节稳定性功能结果以及膝关节活动范围(ROM)。
结果 在年龄、性别、受影响的ACL侧、撕裂至治疗的持续时间和肌肉萎缩方面,两组具有同质性且具有可比性(所有p值>0.05)。在6个月时,大多数患者在拉赫曼试验和前抽屉试验中胫骨平移为0 - 2mm,两组之间无显著差异(两个p值>0.05)。此外,在6个月时,两组的平均Lysholm评分和平均ROM均显著增加(两个p值<0.001)。然而,两组在基线及任何随访时的平均Lysholm评分和平均ROM均无差异(所有p值>0.05)。
结论 在6个月时,采用BPTB和ST/G自体移植物进行ACLR可产生显著且相当的膝关节稳定性、功能结果和ROM。