Rubinstein R A, Shelbourne K D, VanMeter C D, McCarroll J C, Rettig A C
Methodist Sports Medicine Center, Indianapolis, Indiana 46202.
Am J Sports Med. 1994 May-Jun;22(3):324-7. doi: 10.1177/036354659402200305.
To distinguish between morbidity caused by the isolated patellar tendon graft harvest and morbidity associated with anterior cruciate ligament reconstruction when the graft is harvested from the involved knee, we studied 20 patients who had an isolated contralateral graft harvest for anterior cruciate ligament reconstruction in the opposite knee. We defined and quantitated the morbidity by evaluating the uninjured knee from preoperative studies to current followup (range, 0.5 to 5 years; average, 2 years). All graft harvest surgeries were performed in an identical fashion. Rehabilitation of the harvest knee included immediate range of motion, weightbearing, and closed chain kinetic exercises with a emphasis on early strengthening. All patients regained full knee range of motion by 3 weeks. At final followup, there was no clinical or radiographic evidence of patella contracture or baja. Quadriceps strength averaged 69% at 6 weeks and returned to 93% at 1 year and 95% at 2 years. Activity-related soreness at the donor site (patellar tendinitis) was rarely restricting and resolved after the 1st year. No patient complained of patellofemoral joint pain in the donor knee. The modified Noyes subjective questionnaire score averaged 97 of 100 at last followup. The morbidity of an isolated autogenous patellar tendon graft harvest appears to be of short duration and largely reversible.
为了区分单独取髌腱移植物所致的并发症与当从患侧膝关节获取移植物进行前交叉韧带重建时相关的并发症，我们研究了20例在对侧膝关节进行单独取自体髌腱移植物用于前交叉韧带重建的患者。我们通过评估未受伤膝关节从术前检查至当前随访情况（范围0.5至5年；平均2年）来定义并量化并发症。所有取移植物手术均以相同方式进行。取腱膝关节的康复包括立即进行活动度训练、负重训练以及以早期强化为重点的闭链动力性锻炼。所有患者在3周时均恢复了膝关节的完全活动度。在最终随访时，没有临床或影像学证据表明存在髌骨挛缩或低位髌骨。股四头肌力量在6周时平均为69%，在1年时恢复至93%，在2年时恢复至95%。供区与活动相关的酸痛（髌腱炎）很少会限制活动，且在第1年后会缓解。没有患者主诉供区膝关节的髌股关节疼痛。在最后随访时，改良的诺伊斯主观问卷评分平均为100分中的97分。单独取自体髌腱移植物的并发症似乎持续时间较短且大多可逆转。
