A five-year comparison of patellar tendon versus four-strand hamstring tendon autograft for Arthroscopic reconstruction of the anterior cruciate ligament
A five-year comparison of patellar tendon versus four-strand hamstring tendon autograft for Arthroscopic reconstruction of the anterior cruciate ligament
复制标题
DOI：
10.1177/03635465020300041201
复制
发表时间：
2002-07-01
影响因子：
4.8
通讯作者：
Clingeleffer, A
中科院分区：
文献类型：
--
作者：
Pinczewski, LA;Deehan, DJ;Clingeleffer, A
背景资料：前交叉韧带重建术中移植物材料的选择被认为对结果起主要作用，但大多数移植物选择的比较没有得到很好的控制。（髌腱或腘绳肌腱）确实影响前交叉韧带重建后的临床结果。研究设计：前瞻性，非随机临床试验。方法：两组各90例患者进行了为期至少5 years.Results：国际膝关节文献委员会评估显示，超过85%的每组有一个整体评分A或B在所有后续的时间间隔。2年和5年时，两组的中位Lysholm膝关节评分均大于90。仪器测试显示，超过3年，两组之间没有显着差异。5年时，31%的髌腱组（25）有固定屈曲畸形，19%的腘绳肌肌腱组（14）有固定屈曲畸形。放射学评估显示，早期骨关节炎的变化在4%的腘绳肌腱组（2）和18%的髌腱组（11）在5 years.Conclusions：关节镜下重建与任何移植的结果在一个类似的手术结果，可靠地恢复膝关节的稳定性超过5年的时间，但是，患者与髌腱移植物是在发展早期骨关节炎的迹象更大的风险。(C)2002年美国骨科学会运动医学。
Background: The choice of graft material for anterior cruciate ligament reconstruction is believed to play a major role in outcome, but most comparisons of graft choice have not been well controlled.Hypothesis: The choice of graft material (patellar tendon or hamstring tendon) does affect clinical outcome after anterior cruciate ligament reconstruction.Study Design: Prospective, nontrandomized clinical trial.Methods: Two groups of 90 patients each were followed for a minimum of 5 years.Results: International Knee Documentation Committee assessment revealed that more than 85% of each group had an overall score of A or B at all follow-up intervals. The median Lysholm knee score was greater than 90 for both groups at 2 and 5 years. Instrumented testing revealed no significant difference between the two groups beyond 3 years. Thirty-one percent of the patellar tendon group (25) had a fixed flexion deformity and 19% of the hamstring tendon group (14) had fixed flexion deformity at 5 years. Radiologic assessment revealed early osteoarthritic changes in 4% of the hamstring tendon group (2) and in 18% of the patellar tendon group (11) at 5 years.Conclusions: Arthroscopic reconstruction with either graft results in a similar surgical outcome, reliably restoring knee stability over a 5-year period; however, patients with patellar tendon grafts are at greater risk of developing early signs of osteoarthritis. (C) 2002 American Orthopaedic Society for Sports Medicine.