股直肌腱与股四头肌腱及腘绳肌腱自体移植物用于合并前外侧手术的ACL重建术后短期患者报告结局：一项前瞻性比较研究
简介
一项前瞻性非随机研究比较股直肌腱、股四头肌腱与腘绳肌腱自体移植物在ACL重建联合前外侧手术中的短期患者报告结局。90例患者随访至少1年，三组在KOOS疼痛、QoL、EQ-5D-5L、满意度及瘢痕评分上均无显著差异。提示短期移植物选择对PROM无显著影响，但证据等级III级。
英文摘要
PURPOSE: To compare short-term patient-reported outcomes following anterior cruciate ligament reconstruction (ACLR) with concomitant anterolateral procedure, using rectus femoris (RF), quadriceps tendon (QT) and hamstring tendons (HS) autografts. It was hypothesized that short-term patient-reported outcomes would not differ significantly across graft strategies at 1-year follow-up. METHODS: A prospective comparative non-randomized study was conducted, including 90 consecutive patients undergoing primary ACLR between May 2022 and June 2023 (30 per group). Outcomes were assessed at a median follow-up of 15.0 months (range: 12-22) using the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain and Quality of Life (QoL) subscales, EuroQOL 5-dimensions 5-level index (EQ-5D-5L), global satisfaction (0-100) and the Patient and Observer Scar Assessment Scale (POSAS). Continuous variables were compared using one-way analysis of variance with Bonferroni-corrected post hoc comparisons and categorical variables using χ 2 tests. A multivariable logistic regression model was used to assess predictors of POSAS ≤ 20. RESULTS: Of the 90 consecutive patients initially included, one patient in the RF group was excluded following graft failure and revision surgery prior to outcome assessment, leaving 89 patients available for analysis. Mean global satisfaction was 86.5 ± 10.9, KOOS Pain 89.1 ± 13.2, KOOS QoL 71.4 ± 22.2 and EQ-5D-5L Index 0.85 ± 0.15. No statistically significant differences were observed between graft types in KOOS QoL (p = 0.344), KOOS Pain (p = 0.716), EQ-5D-5L (p = 0.386) or POSAS (p = 0.748). Global satisfaction did not differ significantly across graft groups (p = 0.074). CONCLUSION: No statistically significant differences in short-term patient-reported outcomes were observed among RF, QT and HS autografts at 1-year follow-up. Graft strategy was not associated with differences in short-term postoperative patient-reported outcomes within the available sample. LEVEL OF EVIDENCE: Level III.