Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Am J Sports Med. 1995 Nov-Dec;23(6):706-14. doi: 10.1177/036354659502300613.
To distinguish between morbidity caused by harvesting semitendinosus and gracilis tendons and morbidity associated with anterior cruciate ligament reconstruction surgery, we performed a prospective randomized study using 65 patients who underwent anterior cruciate ligament reconstruction using these tendons. The patients underwent either contralateral (N = 34) or ipsilateral (N = 31) graft harvest. For the nonoperated knees in the ipsilateral harvest group, isometric and isokinetic strength of the quadriceps and hamstring muscles increased to approximately 120% of the preoperative value at 12 months after surgery. Compared with these knees, the tendon harvest did not affect quadriceps muscle strength at all. However, harvest did decrease hamstring muscles strength for 9 months after surgery. The graft harvest in the knees with anterior cruciate ligament reconstruction also did not significantly affect quadriceps muscle strength, but it did significantly decrease hamstring muscles strength only at 1 month. Activity-related soreness at the donor site was rarely restricting and resolved by 3 months. This study demonstrated that the semitendinosus and gracilis tendon graft is a reasonable choice to minimize the donor site morbidity in ligament reconstruction using autografts.
为了区分半腱肌和股薄肌腱取材所致的发病率与前交叉韧带重建手术相关的发病率，我们对65例使用这些肌腱进行前交叉韧带重建的患者进行了一项前瞻性随机研究。患者接受了对侧（N = 34）或同侧（N = 31）移植物取材。对于同侧取材组中未手术的膝关节，术后12个月时股四头肌和腘绳肌的等长和等速力量增加到术前值的约120%。与这些膝关节相比，肌腱取材根本不影响股四头肌力量。然而，取材确实在术后9个月降低了腘绳肌力量。前交叉韧带重建膝关节的移植物取材也未显著影响股四头肌力量，但仅在术后1个月时显著降低了腘绳肌力量。供区与活动相关的酸痛很少造成限制，3个月时即可缓解。本研究表明，半腱肌和股薄肌腱移植物是在自体移植韧带重建中尽量减少供区发病率的合理选择。
