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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Graft With and Without a Ligament Augmentation Device: A 25-Year Follow-up of a Prospective Randomized Controlled Trial
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Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Graft With and Without a Ligament Augmentation Device: A 25-Year Follow-up of a Prospective Randomized Controlled Trial

机译：前交叉韧带重建术使用带-或不带韧带增强装置的骨-tell腱-骨移植术：一项为期25年的前瞻性随机对照试验

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Background: Various grafts and ligament augmentation devices (LADs) have been used in the search for optimal reconstruction of the anterior cruciate ligament (ACL). Purpose: To compare 25-year follow-up results after ACL reconstruction using a bone–patellar tendon–bone (BPTB) graft with or without the Kennedy LAD. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: One hundred patients undergoing ACL reconstruction between 1991 and 1993 were randomized into 2 groups: reconstruction using a BPTB graft alone (BPTB group, 51 patients) or a BPTB graft with the Kennedy LAD (LAD group, 49 patients). The 25-year follow-up evaluation included a clinical knee examination, patient-reported outcome measures, and an assessment of radiological osteoarthritis (OA) according to the Ahlb?ck classification. Additional outcomes were reruptures and knee arthroplasty. Results: Ninety-three patients (93%) were available for the follow-up evaluation: 48 patients in the BPTB group and 45 in the LAD group. Through telephone calls, 26 patients were excluded from further investigation because of reruptures and arthroplasty in the knee of interest; 67 patients were further investigated. A total of 43 of 44 (98%) and 42 of 44 (95%) patients had negative or 1+ Lachman and pivot-shift test results, respectively. The mean Lysholm score was 85 for the BPTB group and 83 for the LAD group. All mean Knee injury and Osteoarthritis Outcome Score (KOOS) subscale values were ≥73. There were no statistically significant differences between groups in any of these outcomes or regarding the Tegner score, radiological classification of OA, or number of ACL reruptures. Signs of radiological OA were detected in all patients, and severe radiological OA (Ahlb?ck grade III, IV, or V) was detected in 32% of patients in the BPTB group and 21% of patients in the LAD group ( P = .37). There were 12 patients in the BPTB group and 7 in the LAD group who had documented reruptures ( P = .40). One patient in the BPTB group and 6 in the LAD group underwent knee arthroplasty ( P = .054). Conclusion: In the present study, there were no statistically significant differences between groups in any of the outcomes. After 25 years, 19% of patients had reruptures, 27% had severe radiological OA, and 7% underwent knee arthroplasty.
机译：背景：各种移植物和韧带增强装置（LAD）已用于寻找前十字韧带（ACL）的最佳重建。目的：比较使用带或不带肯尼迪LAD的bone骨腱-骨（BPTB）移植进行ACL重建后25年的随访结果。研究设计：随机对照试验;证据级别：1。方法：将1991年至1993年之间接受ACL重建的100例患者随机分为两组：单独使用BPTB移植进行重建（BPTB组，51例患者）或使用肯尼迪LAD进行BPTB移植（LAD组，49例）耐心）。这项为期25年的随访评估包括临床膝关节检查，患者报告的结局指标以及根据Ahlb？ck分类对放射性骨关节炎（OA）的评估。额外的结果是破裂和膝关节置换术。结果：93例患者（93％）可用于随访评估：BPTB组48例，LAD组45例。通过电话，有26例患者由于感兴趣的膝关节破裂和置换而被排除在进一步调查之外。 67例患者被进一步调查。分别有44例（98％）的43例和44例（95％）的42例Lachman和枢轴位移测试结果阴性。 BPTB组的Lysholm平均评分为85，LAD组的平均Lysholm评分为83。所有平均膝关节损伤和骨关节炎结果评分（KOOS）分量表值均≥73。两组之间在这些结局，Tegner评分，OA的放射学分类或ACL破裂次数方面均无统计学差异。在所有患者中均检测到放射性OA的体征，在BPTB组中32％的患者和LAD组中21％的患者中发现了严重的放射性OA（Ahlb？ck等级III，IV或V）（P =。 37）。 BPTB组中有12例患者有破裂，而LAD组中有7例已证实有破裂（P = .40）。 BPTB组中的1例患者和LAD组中的6例接受了膝关节置换术（P = .054）。结论：在本研究中，两组之间在任何结局方面均无统计学差异。 25年后，有19％的患者复发了血管，27％的患者出现了严重的放射性OA，还有7％的患者接受了膝关节置换术。

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