全内技术下部分腓骨长肌腱自体移植物重建前交叉韧带后的早期恢复与重返工作：一项回顾性队列研究
简介
本研究回顾性比较80例前交叉韧带重建患者，分别采用全内技术联合部分腓骨长肌腱自体移植物与常规腘绳肌腱移植物。结果显示腓骨长肌腱组术后下床活动、辅助行走及重返工作更早，疼痛评分更低、关节活动度更大，短期膝关节稳定性与腘绳肌腱组相当。需注意两组移植物类型与手术技术同时不同，结果反映的是二者联合效应，而非移植物单独作用。
英文摘要
PurposeTo compare early postoperative recovery, return to work (RTW), functional outcomes, and short-term knee stability after all-inside anterior cruciate ligament reconstruction (ACLR) using a partial peroneus longus tendon (PLT) autograft versus conventional hamstring tendon (HT) autograft reconstruction.MethodsThis retrospective cohort study included 80 patients who underwent primary ACLR between October 2022 and October 2023. Forty patients underwent all-inside ACLR using a partial PLT autograft, and 40 underwent conventional HT autograft ACLR. Minimum follow-up was 18 months. Patient-reported outcomes, range of motion, KT-2000 arthrometer side-to-side difference (SSD), clinical stability tests, early rehabilitation milestones, and RTW were evaluated during follow-up. RTW was defined as resumption of preinjury occupational duties without work restrictions.ResultsBoth groups showed postoperative improvement over time. Compared with the HT group, the PLT group achieved earlier out-of-bed mobilization, earlier assisted walking, and earlier RTW across occupational categories (all p < 0.001). The PLT group also had lower postoperative pain scores, greater range of motion, and higher Anterior Cruciate Ligament-Return to Sport after Injury scores during follow-up. Although Lysholm scores were higher in the HT group, International Knee Documentation Committee scores improved in both groups and postoperative Lachman and pivot-shift findings did not differ significantly. KT-2000 SSD was lower in the PLT group, but the final absolute difference was small.ConclusionAll-inside ACLR using a partial PLT autograft was associated with earlier postoperative mobilization and RTW than conventional HT autograft ACLR while maintaining comparable short-term clinical stability. Because graft type and surgical technique differed concurrently between groups, these findings should be interpreted as the combined effect of both factors rather than the isolated effect of graft choice alone.