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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Donor-Site Recovery after Anterior Cruciate Ligament Reconstruction with Contralateral Autogenous Patellar-Tendon Graft
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Donor-Site Recovery after Anterior Cruciate Ligament Reconstruction with Contralateral Autogenous Patellar-Tendon Graft

机译：对侧自体Auto骨腱移植重建前交叉韧带后的供体位点恢复

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Objectives: To evaluate the recovery of the donor site after ACL-reconstruction with a contralateral autogenous patellar tendon graft as compared with an ipsilateral graft. Specifically, we compared the International Knee Documentation Committee (IKDC) subjective scores between groups and compared to established normative data. Furthermore we evaluated quadriceps muscle strength between surgery groups. Methods: Between 2007 and 2009, 279 patients who underwent primary ACL reconstruction with an autogenous patellar tendon graft from the contralateral knee met the inclusion criteria of unilateral knee involvement, no evidence of arthritic changes preoperatively, and minimum 2 year follow-up objective and subjective evaluations. A control group was obtained of 58 patients who had the same inclusion criteria, were of the same age, but underwent surgery with ipsilateral graft. Patients underwent a goal-directed and sequential postoperative rehabilitation program that emphasized controlling a hemarthrosis, obtaining full knee range of motion as soon as possible after surgery, increasing leg strength, and functional activities to return patients back to sports. The rehabilitation for the contralateral donor site emphasized high repetition/low resistance exercises beginning the day after surgery to reconstitute the patellar tendon size and strength. IKDC subjective data was compared between surgery groups and established normative data. Quadriceps muscle strength was evaluated in both knees compared to the pre-operative values obtained in the non-involved knee; strength between knees at 2 years postoperatively was also evaluated. Results: When comparing quadriceps muscle strength to its pre-operative baseline value, the ipsilateral control group that had statistically significantly less strength in the ACL-reconstructed knee at 105% ± 29% compared with the contralateral group that had 114% ± 28.4% strength in the donor knee ( P < .01) and 116% ± 25% strength in the ACL-reconstructed knee ( P = .0339). When side-to-side strength was evaluated at 2 years post-operatively, the contralateral group had 98.4% ± 13.6% quadriceps muscle strength compared with 92.9% ± 13.0% in the ipsilateral control group ( P < .01). The mean total IKDC scores obtained at the 2-year follow-up was 92.4 ± 9.6 for contralateral donor-knee, 88.8 ± 12.3 in the contralateral ACL-reconstructed knee, and 88.9 ± 11.2 for the control group ACL-reconstructed knee (p=0.960). There was also no statistical significant differences between groups for any of the IKDC sub-scores or total score (All P- values >.136; Table 1). The mean IKDC scores compared with established normative data of noninjured people of the same age and sex showed no large effect size differences between groups. Conclusion: With proper rehabilitation after surgery, use of a contralateral bone-patellar tendon-bone autograft with ACL reconstruction does not cause unresolved donor-site strength loss or subjective symptoms.
机译：目的：评估同侧自体tell骨腱腱移植重建ACL后供体部位的恢复情况。具体来说，我们比较了国际膝关节文献委员会（IKDC）之间的主观评分，并与已建立的规范数据进行了比较。此外，我们评估了手术组之间的股四头肌肌肉强度。方法：2007年至2009年间，对有279例行对侧膝关节自体pa骨腱移植的原发性ACL重建患者符合单侧膝关节受累的入选标准，术前无关节炎变化的证据，并且至少进行了2年的客观和主观随访评估。对照组为58例患者，这些患者具有相同的纳入标准，年龄相同，但是接受了同侧移植手术。患者接受了针对目标的，顺序的术后康复计划，该计划强调控制血栓形成，手术后尽早获得膝盖的完整运动范围，增强腿部力量和使患者重返运动的功能活动。对侧供体部位的康复强调从术后第二天开始的高重复性/低阻力运动，以重建pa肌腱的大小和强度。比较手术组之间的IKDC主观数据和已建立的规范数据。与未累及的膝关节获得的术前值相比，评估了两膝的股四头肌肌力。还评估了术后2年时膝盖之间的力量。结果：当比较股四头肌的肌肉力量与其术前基线值时，同侧对照组的ACL重建膝关节的力量在统计学上显着降低，为105％±29％，而对侧对照组为114％±28.4％在供体膝关节中（P <.01）和ACL重建膝关节中116％±25％的强度（P = .0339）。术后2年评估侧向力量时，对侧组的股四头肌肌肉力量为98.4％±13.6％，而同侧对照组为92.9％±13.0％（P <.01）。在2年随访中，对侧供体膝关节的IKDC总平均得分为92.4±9.6，对侧ACL重建膝关节为88.8±12.3，而对照组ACL重建膝关节为88.9±11.2（p = 0.960）。对于任何IKDC子评分或总分，各组之间也没有统计学上的显着差异（所有P值> 0.136;表1）。 IKDC的平均得分与已建立的相同年龄和性别的未受伤人群的标准数据相比，两组之间没有显着的效应大小差异。结论：在手术后适当康复的情况下，使用对侧骨-腱腱自体重建ACL不会导致未解决的供体部位力量丧失或主观症状。

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