Long-term follow-up after anterior cruciate ligament reconstruction using a press-fit quadriceps tendon-patellar bone autograft

被引:24
作者
Barie, Alexander [1 ]
Koepf, Michael [1 ]
Jaber, Ayham [1 ]
Moradi, Babak [1 ]
Schmitt, Holger [3 ]
Huber, Juergen [2 ]
Streich, Nikolaus Alexander [2 ]
机构
[1] Heidelberg Univ Hosp, Clin Orthoped & Trauma Surg, Ctr Orthoped Trauma Surg & Spinal Cord Injury, Schlierbacher Landstr 200a, D-69118 Heidelberg, Germany
[2] Clin St Elisabeth Heidelberg, Ctr Joint Surg & Sport Injuries, Sportopaedie Heidelberg, Max Reger Str 5-7, D-69121 Heidelberg, Germany
[3] Atos Clin Heidelberg, Ctr Orthoped & Sports Trauma Surg, Bismarckstr 9-15, D-69115 Heidelberg, Germany
关键词
Knee; Anterior cruciate ligament; Reconstruction; Quadriceps tendon; Press-fit technique; ACL RECONSTRUCTION; BIOMECHANICAL EVALUATION; FEMORAL FIXATION; GOLD STANDARD; GRAFT; POPULATION; SCALE;
D O I
10.1186/s12891-018-2271-8
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: The use of a quadriceps tendon-patellar bone (QTPB) autograft provides an alternative procedure in primary reconstruction of the anterior cruciate ligament (ACL). Using the press-fit technique for femoral fixation and knotting over a bone bridge as well as additional spongiosa filling for tibial fixation can completely eliminate the need for fixation implants. The objective of this study was to evaluate the long-term clinical, functional and radiological results of this operating method. Methods: Sixty-nine patients (27 female-42 male) were included in this study. Fifty-seven patients (83%) received a comprehensive follow-up review after an average period of 7.5 years (range: 7-8.7). All other patients were surveyed by telephone. Six patients (9%) suffered a re-rupture of the ACL graft caused by a new related trauma and were therefore excluded from the statistical analysis. Results: Of all patients, 98% were satisfied with the operation. Normal or almost normal results were recorded in the subjective IKDC scores form by 88% of the patients. The Lysholm score demonstrated very good and good results in 83% of the patients. Only 1 patient reported minor complaints in the donor area. Seven (12%) patients developed Cyclops syndrome with limited knee extension. This complication was treated arthroscopically within the first year postoperatively. Their results on follow-up were not worse than the results of the patients without Cyclops syndrome. Regarding the 57 patients who received a comprehensive evaluation, the stability test with the KT-1000 Arthrometer yielded a difference of less than 3 mm in the contralateral comparison for 89% of the operated knees. The pivot-shift test was normal in 79% and almost normal in 21%. In the Single-leg Triple Hop Test, patients achieved an average of 98% of the hopping distance attained with the contralateral leg. The radiological examination revealed a slight deterioration in the Kellgren-Lawrence Score in 2 patients. Conclusion: The ACL reconstruction using the QTPB autograft performed with the press-fit technique leads to good results in comparison with published results of established procedures for primary ACL surgery using other autografts. Further investigations should involve comparative studies with the objective of providing evidence-based, individually adapted therapy for ACL rupture.
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页数:9
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