取股直肌腱行前交叉韧带重建术后一年未出现选择性股直肌容积减少或肌力缺损：定量磁共振成像、等速肌力及功能分析
简介
该研究评估了使用四股股直肌腱自体移植物进行前交叉韧带重建（ACLR）术后1年的临床和功能结果，以及供区并发症。共纳入54例患者，平均随访15.7个月。结果显示：平均IKDC评分84.1，Marx活动评分7.1，KT-1000侧-侧胫骨前移差值1.8 mm。术后1年MRI显示，患侧所有股四头肌（股直肌、股外侧肌、股中间肌、股内侧肌）体积均显著小于健侧（p<0.…
英文摘要
PURPOSE: To evaluate 1-year clinical and functional outcomes, as well as donor-site morbidity based on quadriceps muscle morphology, after primary single-bundle ACLR using a quadrupled RF tendon autograft. METHODS: Patients who underwent primary single-bundle ACLR using a quadrupled RF tendon autograft with adjustable suspensory fixation between December 2024 and April 2025 were retrospectively reviewed. Clinical outcomes were assessed using the International Knee Documentation Committee Subjective Knee Form (IKDC), Marx Activity Scale, KT-1000 arthrometer side-to-side difference, and pivot-shift test. Quadriceps muscle volumes, including RF, vastus medialis (VM), vastus lateralis (VL), and vastus intermedius (VI), were measured using magnetic resonance imaging (MRI) at one year postoperatively. Isokinetic strength testing at 60°/s and 240°/s and hop performance tests were performed to determine limb symmetry indexes (LSI). RESULTS: A total of 54 patients were evaluated with a mean follow-up of 15.7 ± 4.2 months. The mean IKDC score was 84.1 ± 9.7, the mean Marx Activity Scale score was 7.1 ± 3.2, and the mean side-to-side anterior tibial translation difference was 1.8 ± 1.2 mm. All quadriceps muscle volumes were significantly lower in the operated limb than in the contralateral limb (p < 0.001). Mean deficits were 9.63% for RF, 8.52% for VL, 7.95% for VI, and 8.08% for VM. No significant difference was observed among the percentage deficits of the four muscles (F = 1.701, p = 0.170). LSI values exceeded 90% in all evaluated strength and functional parameters. No significant side-to-side differences were found in most isokinetic and hop tests, except for 240°/s extension strength (p = 0.03) and triple-hop performance (p < 0.001). CONCLUSION: Primary ACLR using a quadrupled RF tendon autograft resulted in favourable one year clinical and functional outcomes with restoration of limb symmetry. Quantitative MRI analyses demonstrated that RF graft harvest did not result in selective RF muscle volume loss or clinically relevant strength deficit at one year postoperatively.