Reduced Knee Flexion Strength 18 Years After ACL Reconstruction With Hamstring Tendon Versus Patellar Tendon

被引:0
作者
Popovic, Marko [1 ]
Myhre, Julie Rikke [2 ]
Holen, Julie Iren Haugseth [2 ]
Gifstad, Tone [1 ]
Strand, Ingebjorg Lokensgard [3 ]
Strand, Torbjorn [4 ]
Mo, Ingunn Fleten [4 ]
Fischer-Bredenbeck, Cornelia [5 ]
Drogset, Jon Olav [1 ]
机构
[1] Trondheim Reg & Univ Hosp, Dept Orthoped, Princesse Kristinas Gate 3, N-7030 Trondheim, Norway
[2] Norwegian Univ Sci & Technol, Fac Med, Trondheim, Norway
[3] Lovisenberg Diaconal Hosp, Dept Orthoped, Oslo, Norway
[4] Haraldsplass Deaconess Hosp, Dept Orthoped, Bergen, Norway
[5] Haraldsplass Deaconess Hosp, Dept Radiol, Bergen, Norway
关键词
anterior cruciate ligament; patellar tendon; hamstring tendon; ANTERIOR CRUCIATE LIGAMENT; FOLLOW-UP; METAANALYSIS; AUTOGRAFTS; GRAFTS; RISK; SEMITENDINOSUS; DIFFERENCE; REVISION; REGISTRY;
D O I
10.1177/03635465241271524
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Bone-patellar tendon-bone (BPTB) and double-looped semitendinosus and gracilis (hamstring) grafts are commonly used for anterior cruciate ligament (ACL) reconstruction. Short-term and midterm studies show little or no differences between the 2 grafts; however, there are only a few long-term studies to compare results between the 2 grafts.Purpose: To compare the results after using either BPTB grafts or hamstring tendon grafts 18 years after ACL reconstruction.Study Design: Randomized controlled trial; Level of evidence 2.Methods: A total of 114 patients with ACL rupture between 2001 and 2004 were randomized to reconstruction with either a BPTB graft or a hamstring tendon graft. Patients were operated on at 4 major hospitals. The 18-year follow-up evaluation included anterior knee laxity measured with a KT-1000 arthrometer, defined as the primary outcome, while clinical examination (Lachman and pivot-shift tests), isokinetic testing of muscle strength, patient-reported outcome measures, and an assessment of radiographic osteoarthritis using the Kellgren-Lawrence classification were defined as secondary outcomes.Results: A total of 96 patients (84%, 47 BPTB and 49 hamstring grafts) were available for follow-up, 71 of these for clinical examination. Seven of 96 patients were excluded for ACL revision (n = 5) or knee replacement (n = 2) surgery. In total, 25 patients (10 BPTB and 15 hamstring grafts) had undergone additional surgery other than ACL revision or total knee arthroplasty. There were no significant differences between the groups in terms of anterior laxity test with KT-1000 arthrometer (primary outcome). In secondary outcomes, no significant differences between groups were reported regarding clinical examination, patient-reported outcome scores, or radiographic osteoarthritis (Kellgren-Lawrence grade 2-4 for patellofemoral joint [18 hamstring and 14 BPTB] or tibiofemoral joint [20 hamstring and 19 BPTB]), while isokinetic testing revealed that the hamstring group had a 10.7% reduction in mean peak flexion torque compared with the BPTB group at 60 deg/s (df = 59; P = .011). At 60 deg/s the mean total flexion work in the hamstring group was reduced by 17.2% compared with the BPTB group (df = 59; P = .002).Conclusion: The flexion strength in the hamstring group was significantly reduced in the operated knee after 18 years. There were no significant differences between the groups regarding subjective outcomes, patient-reported outcomes, range of motion, clinical and instrumented knee laxity, and the development of osteoarthritis.Registration: NCT05876013 (ClinicalTrials.gov identifier).
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页码:NP29 / +
页数:243
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