从踝到膝：Kitaoka踝-后足评分评估腓骨长肌腱移植物用于ACL重建后的供区并发症——一项前瞻性队列研究
简介
45例单纯ACL断裂患者接受自体腓骨长肌腱（PLT）单束重建，前瞻性随访6个月，供区采用Kitaoka踝-后足评分评估。术后14天评分短暂降至71.42，6个月恢复至99.11，与术前无统计学差异，无踝关节不稳或步态异常。提示PLT供区病损轻微且可逆，作为ACL移植物安全可靠，但样本量小、单中心。
英文摘要
INTRODUCTION: Peroneus longus tendon (PLT) autograft is increasingly used for anterior cruciate ligament (ACL) reconstruction, but concerns persist regarding donor ankle morbidity and potential compromise of lateral ankle stability. This study prospectively evaluated donor-site morbidity after PLT harvest using the Kitaoka Ankle-Hindfoot Scale over a 6-month follow-up period. MATERIALS AND METHODS: This prospective observational cohort study included 45 patients with isolated ACL tears who underwent arthroscopic single bundle ACL reconstruction using autologous full thickness PLT grafts. All patients were operated at a single tertiary-care center. The Kitaoka Ankle-Hindfoot Scale was recorded preoperatively and postoperatively at 14 days, 4 weeks, 12 weeks, and 6 months. Only patients without pre existing ankle or foot pathology were included. Donor ankle pain, function, alignment, and total scores were analyzed using paired t-tests and repeated--measures analysis of variance. RESULTS: The cohort had a mean age of 29.95 years, and the mean interval between injury and surgery was 4.4 months. All patients had normal pre-operative donor ankle function with a mean Kitaoka score of 100. At 14 days, the mean score decreased to 71.42 ± 6.92, indicating transient functional impairment. Scores improved to 92.95 ± 5.19 at 30 days, 97.86 ± 4.63 at 90 days, and 99.11 ± 3.81 at 180 days. The change in total score between pre-operative and 6-month follow-up (100.0 ± 0.0 vs. 99.11 ± 3.81) was not statistically significant (P = 0.064). Component analysis showed no significant deterioration in pain (40 vs. 38.88 ± 3.17; P = 0.160), function (50 vs. 49.74 ± 0.63; P = 0.065), or alignment (10 vs. 10; no change). Between 14 days/30 days and 6 months, the increase in total scores was highly significant (P < 0.0001). At final follow-up, 42 patients (93.3%) had excellent and 3 (6.7%) had good donor ankle function. No cases of ankle instability, gait abnormality, or major functional compromise were observed. CONCLUSION: Harvesting the PLT for ACL reconstruction results in minimal and reversible donor-site morbidity, with donor ankle function returning to near normal levels by 6 months. PLT autograft is a safe and mechanically reliable graft choice with preservation of ankle biomechanics as reflected by sustained Kitaoka Ankle-Hindfoot scores.