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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Fifteen Year Prospective Comparison of Patellar & Hamstring Tendon Grafts for ACL Reconstruction
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Fifteen Year Prospective Comparison of Patellar & Hamstring Tendon Grafts for ACL Reconstruction

机译：ella骨和Ham绳肌腱移植重建ACL的15年前瞻性比较

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Objective: This prospective longitudinal study compares isolated endoscopic ACL reconstruction utilizing 4-strand hamstring tendon (HT) or patellar tendon (PT) autograft over a 15-year period with respect to clinical outcomes and the development of osteoarthritis. Method: 90 consecutive patients with isolated ACL rupture were reconstructed with a PT autograft and 90 patients received HT autograft, with an identical surgical technique. Patients were assessed at 2, 5, 7, 10 and 15 years. Assessment included the IKDC Knee Ligament Evaluation including radiographic evaluation, KT1000, kneeling pain, and clinical outcomes. Results: Subjects who received the PT graft had significantly worse outcomes at 15 years for the variables of radiologically detectable osteoarthritis (p=0.001), motion loss (p=0.02), single leg hop test (p=0.002), participation in strenuous activity (p=0.03), knee related decrease in activity level (p=0.002) and kneeling pain (p=0.03). There was no significant difference between the HT and PT groups in overall IKDC grade (p=0.28). ACL graft rupture occurred in 16% of HT group and 8% of the PT group (p=0.10). Contralateral ACL rupture occurred in significantly more PT patients (24%) than HT patients (12%) (p=0.03). Conclusion: Significant differences have developed at 15 years after surgery which were not seen at earlier reviews. Compared to the HT Group, the PT group had significantly worse outcomes with respect to radiological osteoarthritis, range of motion and functional tests but no significant difference in laxity was identified. There was a high incidence of ACL injury after reconstruction, to both the reconstructed and the contralateral knee.
机译：目的：这项前瞻性纵向研究比较了15年来使用4股绳肌腱（HT）或pa骨肌腱（PT）自体移植进行的独立内镜ACL重建的临床效果和骨关节炎的发展。方法：采用相同的手术技术，对90例连续的ACL破裂孤立的患者进行PT自体移植，90例接受HT自体移植。在2、5、7、10和15岁时对患者进行评估。评估包括IKDC膝关节韧带评估，包括射线照相评估，KT1000，跪痛和临床结果。结果：接受PT移植的受试者在15年时因放射学上可检测到的骨关节炎（p = 0.001），运动减退（p = 0.02），单腿跳试验（p = 0.002），参与剧烈活动的变量而导致的结局明显恶化。 （p = 0.03），与膝盖相关的活动水平降低（p = 0.002）和跪痛（p = 0.03）。 HT组和PT组在整体IKDC评分方面无显着差异（p = 0.28）。 HT组16％和PT组8％发生ACL移植物破裂（p = 0.10）。 PT患者（24％）比HT患者（12％）发生对侧ACL破裂（p = 0.03）。结论：术后15年出现了显着差异，这在早期的评论中没有发现。与HT组相比，PT组在放射性骨关节炎，运动范围和功能检查方面的结局明显较差，但在松弛度方面未发现明显差异。重建后和对侧膝关节ACL损伤的发生率均很高。

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