缝匠肌转移术治疗慢性股四头肌肌腱断裂：一项前瞻性研究。

Sartorius muscle transfer for chronic quadriceps tendon rupture: A prospective study.

作者信息

Pintore Andrea, Pintore Ernesto, Asparago Giovanni, Marsilio Emanuela, Torsiello Ernesto, Galasso Olimpio

机构信息

Department of Trauma and Orthopaedic Surgery, University of Salerno, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.

Department of Orthopaedic Surgery, Istituto Clinico Mediterraneo, Agropoli, Salerno, Campania, Italy.

出版信息

Knee. 2025 Mar;53:79-85. doi: 10.1016/j.knee.2024.11.023. Epub 2024 Dec 12.

DOI:10.1016/j.knee.2024.11.023

PMID:39671806

Abstract

BACKGROUND

Quadriceps tendon rupture (QTR) is an uncommon injury. In chronic QTR there may be a large defect and direct repair is not possible with sutures or transosseous anchors. There is no gold standard surgical procedure for the treatment of chronic QTR. We propose a novel technique in which the quadriceps tendon (QT) is reconstructed using a transfer of ipsilateral sartorius tendon.

METHODS

Between January 2002 and April 2020, 19 patients undergoing sartorius muscle transfer for chronic QTR were prospectively recruited. The Knee Society Score (KSS), range of motion (ROM), and Medical Research Council (MRC) Scale for QT muscle strength were collected preoperatively and at a minimum of 2 years follow up.

RESULTS

The mean age of our cohort was 53.4 ± 9.8 years with a female patient count of 12 (54%). The mean body mass index recorded was 28.5 ± 3.2 kg/m (range 23-30). At the mean follow up of 53.4 ± 28.1 months the mean KSS was 90.9 ± 6.3 (range 80-100) (P < 0.05), the mean ROM was 119.5 ± 9.9° for flexion (range 100-130) (P < 0.05) and the mean extension lag was 3.8 ± 5.1° (range 0-15) (P < 0.05). The mean MRC scale was 4.5 ± 0.7 (range 3-5) (P < 0.05). The most frequent complication was QT hypotrophy; it was noted in 14 patients.

CONCLUSION

Satisfactory clinical outcomes of ipsilateral sartorius muscle transfer for chronic QTR can be expected a mean of 4.4 years after surgery.

摘要

背景

股四头肌肌腱断裂（QTR）是一种罕见的损伤。在慢性股四头肌肌腱断裂中，可能存在较大缺损，无法用缝线或经骨锚进行直接修复。目前尚无治疗慢性股四头肌肌腱断裂的金标准手术方法。我们提出一种新技术，即使用同侧缝匠肌肌腱转移来重建股四头肌肌腱（QT）。

方法

在2002年1月至2020年4月期间，前瞻性招募了19例因慢性股四头肌肌腱断裂接受缝匠肌转移手术的患者。术前及至少随访2年时收集膝关节协会评分（KSS）、活动范围（ROM）以及股四头肌肌力的医学研究委员会（MRC）量表评分。

结果

我们队列的平均年龄为53.4±9.8岁，女性患者12例（54%）。记录的平均体重指数为28.5±3.2kg/m²（范围23 - 30）。平均随访53.4±28.1个月时，平均KSS为90.9±6.3（范围80 - 100）（P<0.05），平均屈曲ROM为119.5±9.9°（范围100 - 130）（P<0.05），平均伸直滞后为3.8±5.1°（范围0 - 15）（P<0.05）。平均MRC量表评分为4.5±0.7（范围3 - 5）（P<0.05）。最常见的并发症是股四头肌萎缩；14例患者出现该情况。