Anatomic single- and double-bundle ACL reconstruction both restore dynamic knee function: a randomized clinical trial-part II: knee kinematics.
Anatomic single- and double-bundle ACL reconstruction both restore dynamic knee function: a randomized clinical trial-part II: knee kinematics.
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DOI：
10.1007/s00167-021-06479-x
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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：
Tashman S;Zandiyeh P;Irrgang JJ;Musahl V;West RV;Shah N;Fu FH
使用高精度动态立体X射线成像，比较ACLR后6个月和24个月下坡跑期间解剖单束（SB）和解剖双束（DB）ACLR之间膝关节运动学的侧侧差异。基于与对侧未受伤膝关节的比较，假设解剖型DB ACLR比SB ACLR更能恢复胫股运动学。年龄在14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。排除了任一膝关节既往损伤或手术、大于1级伴随膝关节韧带损伤或ACL插入部位小于14 mm或大于18 mm的个体。受试者随机接受SB或DB ACLR，使用髌骨块收获10 mm宽的股四头肌肌腱自体移植物，并随访24个月。在术后6个月和24个月，使用动态立体X射线跟踪系统在跑步机下坡跑步期间评估动态膝关节功能。计算三维胫股运动学，并在每个时间点比较四肢（ACLR和未受伤的对侧）。57例受试者接受了随机化（29例DB），51例（89.5%）获得了2年随访。SB和DB解剖ACLR之间的任何主要运动学变量均无显著差异。与研究假设相反，与单束ACLR相比，双束重建并未显示出上级运动学结局。虽然两种手术都不能完全恢复正常的膝关节运动学，但两种解剖重建对于恢复接近正常的动态膝关节功能同样有效。本研究的结果表明SB和DB技术均可用于ACL插入部位平均尺寸的患者。一级
Compare side-to-side differences for knee kinematics between anatomic single-bundle (SB) and anatomic double-bundle (DB) ACLR during downhill running at 6 and 24 months post ACLR using high-accuracy dynamic stereo X-ray imaging. It was hypothesized that anatomic DB ACLR would better restore tibio-femoral kinematics compared to SB ACLR, based on comparison to the contralateral, uninjured knee. 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. Dynamic knee function was assessed during treadmill downhill running using a dynamic stereo X-ray tracking system at 6 and 24 months after surgery. Three-dimensional tibio-femoral kinematics were calculated and compared between limbs (ACLR and uninjured contralateral) at each time point. Fifty-seven subjects were randomized (29 DB) and 2-year follow-up was attained from 51 (89.5%). No significant differences were found between SB and DB anatomic ACLR for any of the primary kinematic variables. Contrary to the study hypothesis, double-bundle reconstruction did not show superior kinematic outcomes compared to the single-bundle ACLR. While neither procedure fully restored normal knee kinematics, both anatomic reconstructions were similarly effective for restoring near-normal dynamic knee function. The findings of this study indicate both SB and DB techniques can be used for patients with average size ACL insertion sites. Level I
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DOI：
10.2174/1874325001206010287
发表时间：
2012
期刊：
The open orthopaedics journal
影响因子：
--
作者：
Getgood A;Spalding T
通讯作者：
Spalding T
影响因子：
2
作者：
Tashman, Scott;Araki, Daisuke
通讯作者：
Araki, Daisuke
影响因子：
2.2
作者：
Anderst, William;Zauel, Roger;Tashman, Scott
通讯作者：
Tashman, Scott
DOI：
10.1097/01.blo.0000197079.26600.09
发表时间：
2006-01-01
影响因子：
4.2
作者：
Andriacchi, Thomas P.;Briant, Paul L.;Koo, Seungbum
通讯作者：
Koo, Seungbum
DOI：
10.1016/j.arthro.2008.05.021
发表时间：
2008-10-01
影响因子：
4.7
作者：
Pombo, Mathew W.;Shen, Wei;Fu, Freddie H.
通讯作者：
Fu, Freddie H.