腓骨长肌腱与腘绳肌腱自体移植物用于前交叉韧带重建术：功能结果与移植物特性的比较研究
简介
本研究比较了80例ACL重建患者分别采用腓骨长肌腱与腘绳肌腱自体移植物的短期疗效。结果显示腓骨长肌腱组移植物长度（8.37 cm）和直径（7.73 mm）均显著大于腘绳肌腱组，术后6周及12周Lysholm评分亦显著更优，并发症发生率两组均较低。作为小样本短期观察性研究，腓骨长肌腱或可作为ACL重建的安全有效替代移植物，但尚需长期随访及随机对照研究验证。
英文摘要
Background Anterior cruciate ligament (ACL) injury is a common orthopedic condition, particularly among young and physically active individuals. ACL reconstruction (ACLR) is widely performed to restore knee stability and improve functional outcomes. Hamstring tendon autografts are commonly used for reconstruction; however, concerns regarding inadequate graft diameter, delayed graft incorporation, and donor site morbidity have led to increasing interest in the peroneus longus tendon as an alternative graft source. The present study compared the functional outcomes and graft characteristics of hamstring tendon and peroneus longus tendon autografts in ACLR. Methods This observational comparative study was conducted in the Department of Orthopedics at Himalayan Institute of Medical Sciences, Dehradun, over a period of 12 months. A total of 80 patients with ACL rupture undergoing primary ACLR were included and divided equally into two groups. Group A included 40 patients reconstructed using hamstring tendon autografts, while Group B included 40 patients reconstructed using peroneus longus tendon autografts. Baseline demographic and clinical characteristics were recorded preoperatively. Functional outcomes were assessed using the Lysholm Knee Scoring Scale preoperatively and at six weeks and 12 weeks postoperatively. Final graft length and diameter were also compared between the groups. Results The mean age of patients was comparable between the hamstring and peroneus groups (30.35 ± 8.58 years vs 30.33 ± 9.35 years; p = 0.990). Male predominance was observed in both groups. The peroneus longus group demonstrated significantly greater graft length (8.37 ± 0.54 cm vs 8.00 ± 0.58 cm; p = 0.004) and graft diameter (7.73 ± 0.57 mm vs 7.40 ± 0.46 mm; p = 0.005) compared to the hamstring group. Preoperative Lysholm scores were comparable between groups (p = 0.410). However, significantly higher postoperative Lysholm scores were observed in the peroneus group at both six weeks (80.70 ± 5.98 vs 74.90 ± 8.11; p = 0.001) and 12 weeks (90.25 ± 3.46 vs 84.57 ± 4.97; p = 0.001). At 12-week follow-up, excellent functional outcomes were achieved in 40.0% of patients in the peroneus group compared to 7.5% in the hamstring group. Postoperative complications were minimal and comparable in both groups, with no cases of graft failure observed during the 12-week follow-up. Conclusions Peroneus longus tendon autograft demonstrated significantly greater graft dimensions and superior short-term functional outcomes compared with hamstring tendon autograft in ACLR. Both grafts were associated with low complication rates. The peroneus longus tendon may be considered a safe and effective alternative graft option for ACLR.