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评估腓骨长肌腱作为自体移植物用于印度女性患者前交叉韧带重建的疗效:一项前瞻性队列研究。

Evaluating the Efficacy of Peroneus Longus Tendon as an Autograft for Anterior Cruciate Ligament Reconstruction in Indian Female Patients: A Prospective Cohort Study.

作者信息

Pilar Anoop, Gm Sandesh, Nedumparampil Mevin M, Kodi Harish, Amravathi Rajkumar, Muniswamy Madan Mohan

机构信息

Orthopaedics, St. John's Medical College Hospital, Bengaluru, IND.

Orthopaedic Surgery, St. John's Medical College Hospital, Bengaluru, IND.

出版信息

Cureus. 2024 Oct 16;16(10):e71665. doi: 10.7759/cureus.71665. eCollection 2024 Oct.

DOI:10.7759/cureus.71665
PMID:39553023
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11568066/
Abstract

Background Anterior cruciate ligament (ACL) injuries are prevalent, especially among active individuals, and are increasingly observed even in Indian women who are not active in sports. ACL reconstruction (ACLR) is commonly performed using various graft options, but optimal choices for women remain debated. The aim of our study was to examine the use of the peroneus longus tendon as an autograft for ACLR in Indian female patients. Materials and methods A prospective cohort study was carried out on 44 non-athlete female patients who met the inclusion criteria. The study evaluates functional outcomes using the International Knee Documentation Committee (IKDC), Lysholm-Tegner, and American Orthopaedic Foot and Ankle Society (AOFAS) scores, as well as knee stability through clinical tests, over a one-year postoperative period. Results The study demonstrates significant improvements in knee function, with substantial increases in IKDC and Lysholm-Tegner scores from preoperative levels (p-value < 0.01), and effective restoration of knee stability, as shown by improved Lachman, Anterior Drawer, and Pivot Shift test results. Moreover, the peroneus longus graft had minimal impact on ankle morbidity, as indicated by consistent AOFAS scores before and after surgery. Conclusion The study highlights the peroneus longus tendon as a viable graft option for ACLR in symptomatic Indian female patients who were not active in sports, offering both mechanical strength and favorable functional outcomes without affecting the ankle strength or the function.

摘要

背景

前交叉韧带(ACL)损伤很常见,尤其是在活跃人群中,甚至在不参加体育活动的印度女性中也越来越多地被观察到。ACL重建(ACLR)通常使用各种移植物进行,但女性的最佳选择仍存在争议。我们研究的目的是检查在印度女性患者中使用腓骨长肌腱作为ACLR的自体移植物的情况。

材料和方法

对44名符合纳入标准的非运动员女性患者进行了一项前瞻性队列研究。该研究在术后一年期间使用国际膝关节文献委员会(IKDC)、Lysholm-Tegner和美国矫形足踝协会(AOFAS)评分评估功能结果,并通过临床测试评估膝关节稳定性。

结果

该研究表明膝关节功能有显著改善,IKDC和Lysholm-Tegner评分较术前水平大幅提高(p值<0.01),并且膝关节稳定性得到有效恢复,Lachman试验、前抽屉试验和轴移试验结果改善证明了这一点。此外,腓骨长肌腱移植物对踝关节发病率的影响最小,手术前后AOFAS评分一致表明了这一点。

结论

该研究强调,对于有症状的、不参加体育活动的印度女性患者,腓骨长肌腱是ACLR的一种可行移植物选择,它既提供机械强度,又能带来良好的功能结果,且不影响踝关节力量或功能。

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本文引用的文献

1
Comparison of Functional Outcomes of an Anterior Cruciate Ligament (ACL) Reconstruction Using a Peroneus Longus Graft as an Alternative to the Hamstring Tendon Graft.使用腓骨长肌腱移植替代腘绳肌腱移植进行前交叉韧带(ACL)重建的功能结果比较。
Cureus. 2023 Apr 7;15(4):e37273. doi: 10.7759/cureus.37273. eCollection 2023 Apr.
2
A prospective study of arthroscopic primary ACL reconstruction with ipsilateral peroneus longus tendon graft: Experience of 439 cases.关节镜下同侧腓骨长肌腱重建前交叉韧带的前瞻性研究:439 例经验。
Medicine (Baltimore). 2023 Mar 3;102(9):e32943. doi: 10.1097/MD.0000000000032943.
3
Birth cohort differences in height, weight and BMI among Indian women aged 15-30 years: analyses based on three cross-sectional surveys.15至30岁印度女性身高、体重和体重指数的出生队列差异:基于三项横断面调查的分析
Public Health Nutr. 2021 Dec 27;25(12):1-10. doi: 10.1017/S1368980021005012.
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Anterior Cruciate Ligament Tear.前交叉韧带撕裂
N Engl J Med. 2019 Jun 13;380(24):2341-2348. doi: 10.1056/NEJMcp1805931.
5
Peroneus longus autograft can be recommended as a superior graft to hamstring tendon in single-bundle ACL reconstruction.在单束 ACL 重建中,腓骨长肌腱自体移植物可作为比腘绳肌腱更优的移植物。
Knee Surg Sports Traumatol Arthrosc. 2019 Nov;27(11):3552-3559. doi: 10.1007/s00167-019-05455-w. Epub 2019 Mar 15.
6
INFLUENCE OF PATIENT DEMOGRAPHICS AND GRAFT TYPES ON ACL SECOND INJURY RATES IN IPSILATERAL VERSUS CONTRALATERAL KNEES: A SYSTEMATIC REVIEW AND META-ANALYSIS.患者人口统计学特征和移植物类型对同侧与对侧膝关节前交叉韧带二次损伤率的影响:一项系统评价和荟萃分析
Int J Sports Phys Ther. 2018 Aug;13(4):561-574.
7
Normative data for the American Orthopedic Foot and Ankle Society ankle-hindfoot, midfoot, hallux and lesser toes clinical rating system.美国矫形足踝协会踝关节-后足、中足、拇趾及小趾临床评分系统的标准数据。
Int Orthop. 2016 Feb;40(2):301-6. doi: 10.1007/s00264-015-3066-2. Epub 2015 Dec 16.
8
The Anterior Cruciate Ligament Reconstruction with the Peroneus Longus Tendon: A Biomechanical and Clinical Evaluation of the Donor Ankle Morbidity.使用腓骨长肌腱进行前交叉韧带重建:供体踝关节并发症的生物力学和临床评估
J Med Assoc Thai. 2015 Jun;98(6):555-60.
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Arthroscopy. 2013 Dec;29(12):1948-53. doi: 10.1016/j.arthro.2013.08.025. Epub 2013 Oct 17.