Brandsson S, Faxén E, Eriksson B I, Kälebo P, Swärd L, Lundin O, Karlsson J
Department of Orthopaedics, Ostra University Hospital, Göteborg, Sweden.
Knee Surg Sports Traumatol Arthrosc. 1998;6(2):82-7. doi: 10.1007/s001670050077.
The most common graft in anterior cruciate ligament (ACL) surgery involves using the central one-third of the patellar tendon. Knowledge concerning the postoperative disability after harvesting the patellar tendon is, however, limited. The aim of this study was to evaluate the impact patellar tendon suture and bone grafting of the patellar bone defect might have in terms of functional outcome and patellofemoral pain after harvesting the bone-tendon-bone graft, compared with leaving the harvested site non-sutured and non-grafted. Sixty patients, scheduled for arthroscopically assisted ACL reconstruction, were randomly allocated to two groups. In group I, suture of the patellar tendon and bone grafting of the patellar defect were performed. In group II, the tendon gap and the patellar defect were left open. Preoperatively, there was no significant difference between the groups when comparing objective knee stability, as measured with a KT-1000 laxity meter, Lysholm score, Tegner activity level, IKDC score, or patello-femoral pain score. Both groups had a significantly improved Lysholm score at the 2-year follow-up, without any difference between them. Tegner's activity level was significantly lower at follow-up, compared with the pre-injury level in both groups. The patellofemoral pain score improved significantly after the reconstruction, without any difference between the groups. Ultrasonography did not reveal any difference between the groups in terms of healing of the tendon gap. This study revealed no differences in donor site morbidity, functional outcome, patellofemoral pain score or knee joint stability between the two treatment groups. The conclusion is that suture of the patellar tendon and bone grafting of the patellar defect do not improve the functional results or reduce donor site morbidity after arthroscopically assisted ACL.
前交叉韧带（ACL）手术中最常用的移植物是髌腱中央三分之一。然而，关于髌腱取材后的术后功能障碍的知识有限。本研究的目的是评估与不缝合、不植骨的取材部位相比，髌腱缝合和髌骨骨缺损植骨对取材后的肌腱-骨移植物功能结局和髌股关节疼痛的影响。60例计划行关节镜辅助下ACL重建的患者被随机分为两组。第一组进行髌腱缝合和髌骨缺损植骨。第二组，肌腱间隙和髌骨缺损不做处理。术前，使用KT-1000松弛度测量仪、Lysholm评分、Tegner活动水平、IKDC评分或髌股关节疼痛评分比较客观膝关节稳定性时，两组之间无显著差异。两组在2年随访时Lysholm评分均显著改善，且两组之间无差异。与两组受伤前水平相比，随访时Tegner活动水平显著降低。重建后髌股关节疼痛评分显著改善，两组之间无差异。超声检查未显示两组在肌腱间隙愈合方面存在差异。本研究表明，两组在供区并发症、功能结局、髌股关节疼痛评分或膝关节稳定性方面无差异。结论是，髌腱缝合和髌骨缺损植骨并不能改善关节镜辅助下ACL重建后的功能结果，也不能降低供区并发症。
