Reconstruction of the anterior cruciate ligament: a comparison between bone-patellar tendon-bone grafts and fourstrand hamstring grafts
Reconstruction of the anterior cruciate ligament: a comparison between bone-patellar tendon-bone grafts and fourstrand hamstring grafts
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前交叉韧带重建：骨-髌腱-骨移植物与四股腘绳肌移植物的比较
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发表时间：
2014
影响因子：
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通讯作者：
M. Najafi
中科院分区：
文献类型：
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作者：
M. Razi;M. Sarzaeem;G. Kazemian;F. Najafi;M. Najafi
背景：前交叉韧带（ACL）断裂是膝关节常见的韧带损伤。移植物（ACL）重建的选择仍然存在争议。这项前瞻性随机临床试验旨在比较骨-髌腱-骨（BPTB）移植物和四股半腱肌-股薄肌（ST）移植物用于ACL重建的3年随访结果。方法：2008年至2009年收治ACL撕裂患者71例，平均年龄（29± 4. 5）岁。46例患者接受了BPTB自体移植物重建，41例患者接受了ST自体移植物治疗。末次随访时，对髌骨组37例患者和腘绳肌组34例患者的恢复至损伤前活动水平、疼痛、膝关节稳定性、活动度、IKDC（国际膝关节文献委员会）评分和并发症进行评价。结果：随访36个月时，BPTB组和ST组IKDC评分分别为34例（92%）和28例（82%），两组间无显著性差异（p > 0.05）。BPTB组的活性高于BPTB组（p> 0.05）。随访3年时，BPTB组和ST组分别有23例（62%）和11例（32%）患者的Lachman试验正常（p=0.019）。在最后一次随访时，髌骨和腘绳肌组分别有29例（79%）和15例（44%）患者的移位试验正常（p=0.021），两组在大腿围差、积液、膝关节活动度、疼痛和并发症方面无显著差异。结论：结果表明，与髌骨肌腱相比，接受自体腘绳肌移植重建的患者的移植物松弛度和移位等级有增加的趋势。然而，两组在活动水平和膝关节功能方面具有可比性。
Background: Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The choice of graft for (ACL) reconstruction remains controversial. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis (ST) grafts for ACL reconstruction over a 3-year follow-up interval. Methods: Seventy-one patients with an average age of 29± 4.5yearswere treated for torn ACL between 2008 and 2009. Forty-sixpatients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. At the time of final follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC (International Knee Documentation Committee) score and complications. Results: At 36thmonth of follow-up, 34 (92%) and 28 (82%) patients in BPTB and ST group, respectively had good-to-excellent IKDC score (p > 0.05). The activity levels were higher in BPTB group (p> 0.05). At 3rd yearof follow up, the Lachman test was graded normal, for 23 (62%) and 11 (32%) patients in BPTB and ST group, respectively (p=0.019). Regarding the pivot-shift test, 29 (79%) and 15 (44%) patients in patella and hamstring group, respectively had normal test at the latest follow-up (p=0.021).There were no significant differences in terms of thigh circumference difference, effusion, knee range of motion, pain and complications. Conclusion: The results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level and knee function.
DOI：
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发表时间：
2006
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