Novaretti João Victor, Dias Junior Claudio Paula Pessoa, Lima Lucas Santos, Amaro Joicemar Tarouco, Gomes Daniel Esperante, Cohen Moises
Departamento de Ortopedia e Traumatologia, Centro de Ortopedia e Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Instituto Cohen, São Paulo, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Dec 21;59(6):e868-e875. doi: 10.1055/s-0044-1785663. eCollection 2024 Dec.
To compare the clinical outcomes of anterior cruciate ligament (ACL) reconstruction using autografts with and without internal brace augmentation. Data from patients who underwent ACL reconstruction with hamstring and quadriceps tendon autografts, with a minimum follow-up of one year, with or without internal brace augmentation were collected prospectively analyzed retrospectively. The Lysholm and Tegner functional scores were collected before and after surgery, as well as data on postoperative complications. For the comparison of means of the two groups, we used the Student test or the Mann-Whitney non-parametric test, when the assumption of normality of the data was rejected. In total, 55 patients underwent ACL reconstruction with internal brace augmentation and another 55 patients underwent ACL reconstruction without internal brace augmentation. The patients were aged between 16 and 63 years (mean of 32.7 ± 11.4 years). A total of 62 patients (56.4%) underwent ACL reconstruction with hamstring graft, and 19 patients (17.3%), with quadriceps tendon graft, with a diameter variation of 7 mm to 11 mm (mean of 8.95 ± 0.83 mm). The postoperative scores did not differ between the groups ( > 0.05). Regarding the group submitted to ACL reconstruction with internal brace augmentation, 4 patients had complications: @ cases of arthrofibrosis, 2 (3.7%); 1 case of rerupture (1.8%); and 1 case of thrombosis (1.8%). In the group submitted to ACL reconstruction without augmentation, 7 patients manifested complications: 2 cases of arthrofibrosis (3.9%); 4 cases of rerupture (7.3%); and 1 case of infection (2%). The results of the present study show that fewer cases of ACL rerupture were observed after reconstruction with internal brace augmentation when compared with ACL reconstruction without augmentation, although no differences in functional scores were found.
比较使用自体移植物且有或无内置支撑增强的前交叉韧带(ACL)重建的临床结果。前瞻性收集接受腘绳肌和股四头肌肌腱自体移植物进行ACL重建且随访至少一年、有或无内置支撑增强的患者数据,并进行回顾性分析。收集手术前后的Lysholm和Tegner功能评分以及术后并发症数据。对于两组均值的比较,当数据正态性假设被拒绝时,我们使用Student检验或Mann-Whitney非参数检验。
总共55例患者接受了内置支撑增强的ACL重建,另外55例患者接受了无内置支撑增强的ACL重建。患者年龄在16至63岁之间(平均32.7±11.4岁)。共有62例患者(56.4%)接受了腘绳肌移植物的ACL重建,19例患者(17.3%)接受了股四头肌肌腱移植物的ACL重建,移植物直径在7毫米至11毫米之间(平均8.95±0.83毫米)。两组术后评分无差异(P>0.05)。在接受内置支撑增强的ACL重建组中,4例患者出现并发症:2例关节纤维化(3.7%);1例再断裂(1.8%);1例血栓形成(1.8%)。在未进行增强的ACL重建组中,7例患者出现并发症:2例关节纤维化(3.9%);4例再断裂(7.3%);1例感染(2%)。
本研究结果表明,与无增强的ACL重建相比,内置支撑增强的重建术后观察到的ACL再断裂病例较少,尽管功能评分未发现差异。