Doğar Fatih, Dere Kadir Ismail, Bilal Okkeş, Topak Duran, Altun Ibrahim, Kuşcu Burak, Özdemir Mustafa Abdullah, Gültekin Muhammed Zeki, Kizildağ Betül
Department of Orthopaedic and Traumatology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Kayseri City Hospital, Clinical of Orthopaedic and Traumatology, Kocasinan, Kayseri, Turkey.
Medicine (Baltimore). 2025 Feb 28;104(9):e41622. doi: 10.1097/MD.0000000000041622.
It was aimed to reveal the effects of 2 different techniques [Endobutton Continuous Loop (CL), ZipLoop technique] used for graft fixation in anterior cruciate ligament (ACL) reconstruction on bone tunnel enlargement and clinical results. Patients who underwent arthroscopic ACL reconstruction using hamstring tendon graft due to ACL rupture between January 2016 and December 2020 were retrospectively analyzed. The study included 80 patients who were operated on by the same surgical team in the same clinic. Forty patients who underwent repair using the suspension system ZipLoop technique were classified as Group 1, and 40 patients who underwent repair using the Endobutton CL technique were classified as Group 2. Plain radiography and MRI were used to evaluate bone tunnel widening. Visual analog scale (VAS), International Knee Documentation Committee (IKDC) knee assessment score, and Lysholm scores were evaluated at the last follow-up to evaluate clinical outcomes. When bone tunnel enlargement was evaluated between the groups, femoral and tibial tunnel enlargement was found to be greater and statistically significant in Group 2 patients in direct radiography measurements. No statistically significant difference was found in tunnel enlargement in MRI measurements (P > .05). However, in MRI measurements, the graft apex-tunnel apex distance was found to be greater and statistically significant in Group 2 patients (P < .05). When the clinical results of both groups were compared, no statistically significant difference was found in VAS, IKDC and Lsyholm scores (P > .05). The graft fixation method affects bone tunnel enlargement. However, it was observed that this had no effect on clinical results.
本研究旨在揭示前交叉韧带(ACL)重建术中用于移植物固定的两种不同技术[Endobutton连续环(CL)、ZipLoop技术]对骨隧道扩大及临床结果的影响。对2016年1月至2020年12月因ACL断裂接受关节镜下ACL重建且使用腘绳肌腱移植物的患者进行回顾性分析。该研究纳入了在同一诊所由同一手术团队进行手术的80例患者。40例采用悬吊系统ZipLoop技术进行修复的患者被分为第1组,40例采用Endobutton CL技术进行修复的患者被分为第2组。采用X线平片和MRI评估骨隧道增宽情况。在末次随访时采用视觉模拟评分法(VAS)、国际膝关节文献委员会(IKDC)膝关节评估评分及Lysholm评分评估临床结果。在评估两组间骨隧道扩大情况时,直接X线测量发现第2组患者的股骨和胫骨隧道扩大更明显且具有统计学意义。MRI测量中隧道扩大情况未发现统计学差异(P>0.05)。然而,在MRI测量中,第2组患者的移植物顶端-隧道顶端距离更大且具有统计学意义(P<0.05)。比较两组的临床结果时,VAS、IKDC和Lysholm评分未发现统计学差异(P>0.05)。移植物固定方法影响骨隧道扩大。然而,观察发现这对临床结果无影响。