外侧关节外肌腱固定术可改善前交叉韧带重建患者的功能运动结果。
Lateral extra-articular tenodesis improves functional movement outcomes in ACL reconstruction patients.
作者信息
Thomas Luyckx, Zhishen Wen, Louis Kluyskens, Thomas Tampere, Jos Vanrenterghem, Kurt Claeys
机构信息
Department of Orthopedic Surgery AZ Delta Roeselare Roeselare Belgium.
Department of Rehabilitation Sciences KU Leuven Brugge Belgium.
出版信息
J Exp Orthop. 2025 May 19;12(2):e70269. doi: 10.1002/jeo2.70269. eCollection 2025 Apr.
PURPOSE
The primary aim was to evaluate the functional impact of adding lateral extra-articular tenodesis (LET) to an anterior cruciate ligament (ACL) reconstruction (ACLR). The secondary aim was to assess whether LET provides benefits in muscle strength, patient-reported outcome measures (PROMs) and return to sport (RTS) pass rate, as well as to examine the influence of meniscal injury on performance in ACLR patients.
METHODS
A retrospective cohort of prospectively collected data on all ACL procedures was performed at AZ Delta Roeselare between 2017 and 2019. The patients followed a 7-month rehabilitation programme and were assessed according to standardised RTS criteria. Patients were divided into two groups according to whether they received LET technique or not, and then each group was further divided based on the presence or absence of meniscal injury. The primary outcomes were the functional movement tests including agility t-test and hop tests. The secondary outcomes were the muscle strength, PROMs and RTS pass rate. A two-way ANCOVA test or a non-parametric test was used to investigate clinical and functional differences among the four groups.
RESULTS
A total of 105 ACL injury patients who underwent ACLR with or without LET were included. The cohort consisted of 74 males and 31 females, with an average age of 25.0 ± 6.2 years. Significantly statistical differences among groups were found for the functional movement tests at 7 months post-operatively in favour of the ACLR with LET groups compared with isolated ACLR groups (agility t-test: 95% confidence interval [CI] 0.3-1.2, = 0.003; cross-over hop test: injured leg: 95%CI 20-86, = 0.002; uninjured leg: 95%CI 12-76, = 0.008; triple hop test: injured leg: 95%CI 7-77, = 0.019). There were no significant differences in muscle strength, PROMs or RTS pass rates among the groups. Meniscal injury had no significant effect on any variable of interest.
CONCLUSION
The addition of a LET procedure to an ACLR showed important improvements in functional movement outcomes at 7 months post-operatively with no negative effect on muscle strength or PROMs.
LEVEL OF EVIDENCE
Level III.
目的
主要目的是评估在前交叉韧带重建术（ACLR）中增加外侧关节外肌腱固定术（LET）的功能影响。次要目的是评估LET在肌肉力量、患者报告结局指标（PROMs）和恢复运动（RTS）通过率方面是否具有益处，以及研究半月板损伤对ACLR患者手术效果的影响。
方法
对2017年至2019年在AZ Delta Roeselare进行的所有ACL手术的前瞻性收集数据进行回顾性队列研究。患者接受为期7个月的康复计划，并根据标准化的RTS标准进行评估。根据患者是否接受LET技术将其分为两组，然后每组再根据是否存在半月板损伤进一步分组。主要结局指标是功能运动测试，包括敏捷性t检验和单腿跳测试。次要结局指标是肌肉力量、PROMs和RTS通过率。使用双向协方差分析或非参数检验来研究四组之间的临床和功能差异。
结果
总共纳入了105例接受或未接受LET的ACL损伤并进行ACLR的患者。该队列包括74名男性和31名女性，平均年龄为25.0±6.2岁。术后7个月的功能运动测试结果显示，与单纯ACLR组相比，接受ACLR联合LET组有显著统计学差异（敏捷性t检验：95%置信区间[CI] 0.3 - 1.2，P = 0.003；交叉单腿跳测试：患侧腿：95%CI 20 - 86，P = 0.002；健侧腿：95%CI 12 - 76，P = 0.008；三级单腿跳测试：患侧腿：95%CI 7 - 77，P = 0.019）。各组之间在肌肉力量、PROMs或RTS通过率方面无显著差异。半月板损伤对任何感兴趣的变量均无显著影响。
结论
在ACLR中增加LET手术在术后7个月时显示出功能运动结局的重要改善，且对肌肉力量或PROMs无负面影响。
证据级别
三级。
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