The effect of early motion on tibial tunnel widening after anterior cruciate ligament replacement using hamstring tendon grafts
The effect of early motion on tibial tunnel widening after anterior cruciate ligament replacement using hamstring tendon grafts
复制标题
DOI：
10.1016/j.arthro.2004.04.069
复制
发表时间：
2004-07-01
影响因子：
4.7
通讯作者：
Paessler, HH
中科院分区：
文献类型：
--
作者：
Hantes, ME;Mastrokalos, DS;Paessler, HH
目的：本研究的目的是评估早期活动增加自体腘绳肌移植物置换前交叉韧带（ACL）患者胫骨隧道扩大的假设。研究类型：队列分析研究。方法：本研究中所有患者均接受了双股半腱肌和股薄肌移植。采用无植入物技术将移植物固定到位。对两组患者进行了评价。A组35例，行单纯ACL置换术，康复方案包括早期活动。B组20例，行关节镜下踝关节修复联合ACL置换术。建议这些患者部分负重并限制活动范围6周。两组之间仅有的2个变量是尿道修复和术后康复。在术后3、6和12个月对患者进行临床和影像学评价。校正影像学放大后，在前后位和侧位片上测量胫骨隧道的远端（T1）、中间（T2）和近端（T3）位置。结果如下：在1年随访评价时，在前后位和侧位视图中，除一个位置（前后位，T1）外，所有位置的早期活动组的隧道扩大均显著较高。两组中隧道中部（T2）的扩大更大。A、B两组的平均百分比分别为45.92%、23.34%（P
Purpose: The purpose of this study was to evaluate the hypothesis that early motion increases tibial tunnel enlargement in patients who underwent anterior cruciate ligament (ACL) replacement with hamstring autograft. Type of Study: Cohort analytic study. Methods: All patients in this study had received a doubled semitendinous and gracilis graft. Grafts were secured in place with an implant-free technique. Two groups of patients were evaluated. Group A consisted of 35 patients who underwent isolated ACL replacement and whose rehabilitation protocol included early motion. Group B consisted of 20 patients who underwent combined arthroscopic meniscal repair and ACL replacement. Partial weight bearing and restriction of range of motion for 6 weeks was recommended for these patients. The only 2 variables between the groups were the meniscal repair and the postoperative rehabilitation. Patients were evaluated clinically and radiographically at 3, 6, and 12 months postoperatively. After correction for radiographic magnification, the tibial tunnel was measured at distal (T1), middle (T2), and proximal (T3) locations on both anteroposterior and lateral views. Results: At 1-year follow-up evaluations, tunnel enlargement was significantly higher in the group with early motion, in both the anteroposterior and lateral views, in all but one location (anteroposterior, T1). The enlargement was greater in the mid-portion (T2) of the tunnel in both groups. The mean percentage was 45.92% for group A and 23.34% for group B (P