三种不同自体移植物ACL重建的临床结果
简介
一项纳入35例ACL重建患者的前瞻性队列研究，比较股直肌、腘绳肌腱与髌腱自体移植物术后6个月内的临床功能结局，评估指标包括疼痛、Lysholm评分及关节活动度。结果显示三组间各时点疼痛评分及功能恢复均无显著差异，移植物类型不影响早期预后；股直肌自体移植物可作为ACL重建的可行替代选择，但需更大样本量及长期随访进一步验证。
英文摘要
OBJECTIVE: To compare short-term clinical and functional outcomes (0-6 months) of Anterior Cruciate Ligament (ACL) reconstruction using rectus femoris autograft versus established graft options. METHODS: Prospective cohort study (Level II) including 35 patients who underwent ACL reconstruction between 2024 and 2025. Pain, Lysholm score, and range of motion (ROM) were assessed preoperatively, on postoperative day (POD) 1, POD 15, and at six months. Statistical analysis included ANOVA, Kruskal-Wallis tests, and linear mixed-effects models (α = 0.05). RESULTS: The sample (15 hamstring, 11 rectus femoris, and 9 patellar tendon grafts) was homogeneous (p < 0.05). Significant improvements over time were observed in Lysholm scores (p < 0.001) and knee flexion ROM (p < 0.001), with no influence of graft type (p = 0.167 and p = 0.177, respectively). On POD 1, pain scores were similar among groups (p = 0.701), with mean Visual Analog Scale (VAS) values of 2.20 (hamstrings), 2.18 (rectus femoris), and 1.78 (patellar tendon). On POD 15, mean pain scores were 1.27, 1.73, and 3.00, respectively, remaining statistically comparable (p = 0.149). CONCLUSION: ACL reconstruction using the rectus femoris autograft demonstrates clinical and functional outcomes equivalent to patellar tendon and hamstring grafts within the first six months postoperatively. Level of Evidence II; Prospective cohort study.