前交叉韧带翻修重建术中同侧伸膝装置自体移植物与腘绳肌腱自体移植物中期股四头肌力量比较
简介
该研究纳入53例翻修ACL重建患者，根据初次及翻修手术中使用的自体移植物分为三组：腘绳肌腱→伸膝装置（HT/Ext）、伸膝装置→腘绳肌腱（Ext/HT）、伸膝装置→伸膝装置（Ext/Ext）。术后6个月测量等速股四头肌力量对称指数（Q-LSI）。结果显示，Ext/HT组Q-LSI（88%）显著优于Ext/Ext组（69%，P=0.028）和HT/Ext组（7…
英文摘要
BACKGROUND: Primary anterior cruciate ligament reconstructions (ACLRs) with extensor mechanism autografts (bone-patellar tendon-bone [BTB] or quadriceps tendon [QT]) have been reported to have lower quadriceps strength symmetry outcomes 6 months postoperatively as compared with those using a hamstring tendon (HT) autograft. However, the influence of a recurrent ipsilateral extensor mechanism graft harvest for a revision ACLR on quadriceps strength symmetry recovery is not well known. PURPOSE: To investigate the effect of ipsilateral revision ACLR autograft selection on the recovery of quadriceps limb symmetry index (Q-LSI) 6 months after a revision ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: After revision ACLR, 53 patients were divided into 3 groups based on the ipsilateral autograft utilized for the primary and revision ACLR: hamstring to extensor (HT/Ext; ie, BTB or QT), extensor to hamstring (Ext/HT), and extensor to extensor (Ext/Ext). Six months after revision ACLR, patients completed an isometric quadriceps strength testing protocol on an isokinetic dynamometer; Q-LSI and quadriceps peak torque relative to body weight were then calculated and used for analysis. Separate analyses of covariance were conducted for each outcome using a multivariable linear regression framework, with group as the primary independent variable and age, sex, body mass index, and time since surgery included as covariates. RESULTS: The Ext/HT group exhibited significantly greater quadriceps strength symmetry (Q-LSI = 88%) than the Ext/Ext group (Q-LSI = 69%; P = .028) and the HT/Ext group (Q-LSI = 70%; P = .005) 6 months after a revision ACLR. At the 6-month testing timepoint after a revision ACLR, no significant differences in Q-LSI were observed between the Ext/Ext group (Q-LSI = 69%) and HT/Ext group (Q-LSI = 70%; P = .99). CONCLUSION: As compared with HT autografts, an ipsilateral BTB or QT autograft for a revision ACLR is associated with significantly lower Q-LSI values at the 6-month postoperative timepoint, regardless of the autograft type used for the primary ACLR.