Clark R, Olsen R E, Larson B J, Goble E M, Farrer R P
North Valley Surgical Associates, American Fork, Utah 84770, USA.
Arthroscopy. 1998 Apr;14(3):258-67. doi: 10.1016/s0749-8063(98)70141-0.
A new method of femoral fixation for arthroscopic anterior cruciate ligament (ACL) reconstruction using semitendinosus and gracilis (ST/G) tendons is presented. Biomechanical evaluation of the method was performed with pullout tests using animal tissues simulating fixation of ST/G tendons passing around a 2.5-mm pin placed transversely through a femoral tunnel. Clinical assessment of 22 patients was performed according to IKDC, Tegner, Lysholm, isokinetic strength, and KT1000 standards. Fixation strengths ranged from 725 N to 1,600 N for yield and maximal loads to failure for 35-mm to 70-mm cross-pins. Clinical results at mean follow-up of 30 months showed one traumatic failure, IKDC 86% normal or nearly normal, Tegner 6 ave, Lysholm 93 ave, KT1000 86% < 3 mm side-to-side difference on maximal manual evaluation, and isokinetic strength testing of quadriceps 8% deficit with hamstrings 8% deficit. Cross-pin fixation of ST/G tendons may be one of the strongest modes of femoral graft attachment yet devised. Our clinical outcomes in this initial series compare well with previous reports of ACL reconstruction regardless of graft or technique.
本文介绍了一种使用半腱肌和股薄肌（ST/G）肌腱进行关节镜下前交叉韧带（ACL）重建时股骨固定的新方法。使用动物组织进行拔出试验对该方法进行生物力学评估，模拟ST/G肌腱绕过横向穿过股骨隧道的2.5毫米销钉的固定情况。根据IKDC、Tegner、Lysholm、等速肌力和KT1000标准对22例患者进行了临床评估。35毫米至70毫米交叉销钉的屈服强度和最大破坏载荷范围为725牛至1600牛。平均随访30个月的临床结果显示1例创伤性失败，IKDC显示86%正常或接近正常，Tegner评分为6分，Lysholm评分为93分，KT1000在最大手动评估时86%的患者两侧差异<3毫米，股四头肌等速肌力测试有8%的不足，腘绳肌有8%的不足。ST/G肌腱的交叉销钉固定可能是目前设计出的最强的股骨移植物附着方式之一。在这个初始系列中，我们的临床结果与之前关于ACL重建的报告相比，无论移植物或技术如何，都表现良好。
