Anatomic single vs. double-bundle ACL reconstruction: a randomized clinical trial-Part 1: clinical outcomes.
Anatomic single vs. double-bundle ACL reconstruction: a randomized clinical trial-Part 1: clinical outcomes.
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DOI：
10.1007/s00167-021-06585-w
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Fu FH
中科院分区：
文献类型：
--
作者：
Irrgang JJ;Tashman S;Patterson CG;Musahl V;West R;Oostdyk A;Galvin B;Poploski K;Fu FH
比较解剖单束（SB）与解剖双束（DB）前交叉韧带重建（ACLR）的临床效果。据推测，与SB ACLR相比，解剖性DB ACLR会导致更好的国际膝关节文献委员会主观膝关节形态（IKDC-SKF）评分，并减少前关节和旋转松弛。年龄在14岁至50岁之间，在受伤后12个月内出现的活跃个体有资格参加。既往双膝损伤或手术，大于1级膝韧带合并损伤，或ACL插入部位小于14mm或大于18mm的个体被排除在外。受试者随机接受SB或DB ACLR和10mm宽的自体股四头肌腱移植术，术后随访24个月。主要结局指标包括IKDC-SKF和KT-1000（侧侧差异）和枢轴移位试验。其他次要结果包括体育活动和参与、活动范围（ROM）和再损伤的测量。由于与髌骨栓摘取相关的髌骨骨折，该研究的登记被暂停。当时，57名受试者（29 DB）被随机分配，其中51名（89.5%）获得了两年的随访。在24个月的随访中，没有发现组间主要结果的差异。21例（77.8%）DB和20例（83.3%）SB在术后2年恢复损伤前运动（ns） 3例（2例DB，占总数的5.3%）持续移植物破裂，5例（4例SB，占总数的8.8%）随后发生半月板损伤。由于研究的早期终止，在ACL插入位置范围为14 ~ 18mm的个体中，采用自体股四头肌腱移植骨块进行解剖性SB和DB ACLR的临床结果没有可检测到的差异。二级在线版本包含补充材料，可在10.1007/s00167-021-06585-w获得。
Compare clinical outcomes of anatomic single-bundle (SB) to anatomic double-bundle (DB) anterior cruciate ligament reconstruction (ACLR). It was hypothesized that anatomic DB ACLR would result in better International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) scores and reduced anterior and rotatory laxity compared to SB ACLR. Active individuals between 14 and 50 years of age that presented within 12 months of injury were eligible to participate. Individuals with prior injury or surgery of either knee, greater than a grade 1 concomitant knee ligament injury, or ACL insertion sites less than 14 mm or greater than 18 mm were excluded. Subjects were randomized to undergo SB or DB ACLR with a 10 mm-wide quadriceps tendon autograft harvested with a patellar bone block and were followed for 24 months. The primary outcome measures included the IKDC-SKF and KT-1000 (side to side difference) and pivot shift tests. Other secondary outcomes included measures of sports activity and participation, range of motion (ROM) and re-injury. Enrollment in the study was suspended due to patellar fractures related to harvest of the patellar bone plug. At that time, 57 subjects had been randomized (29 DB) and two-year follow-up was attained from 51 (89.5%). At 24-month follow-up there were no between-group differences detected for the primary outcomes. Twenty-one (77.8%) DB’s and 20 (83.3%) SB’s reported returning to pre-injury sports 2 years after surgery (n.s) Three subjects (2 DB’s, 5.3% of total) sustained a graft rupture and 5 individuals (4 SB’s, 8.8% of total) had a subsequent meniscus injury. Due to the early termination of the study, there were no detectable differences in clinical outcome between anatomic SB and DB ACLR when performed with a quadriceps tendon autograft with a bone block in individuals with ACL insertion sites that range from 14 to 18 mm. Level 2 The online version contains supplementary material available at 10.1007/s00167-021-06585-w.
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作者：
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DOI：
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