Achilles Tendon-Bone Allograft is Advantageous for Chronic Patellar Tendon Ruptures Using a Modified Fixation Technique

IF 0.2 Q4 ORTHOPEDICS Techniques in Orthopaedics Pub Date : 2022-06-28 DOI:10.1097/BTO.0000000000000595
S. Keyhani, M. Movahedinia, Farzad Amouzadeh, Naser Ghanbari
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Abstract

Objectives: A patellar tendon rupture is an extremely disabling extensor mechanism injury. This follow-up study describes the clinical and radiologic outcomes of a new modified technique for reconstructing chronic patellar tendon ruptures. Materials and Methods: From 2014 to 2018, we reconstructed 15 chronic patellar tendon ruptures using Achilles tendon-bone allograft. Clinical and radiologic outcomes were evaluated preoperatively and during the final follow-up, 2 to 7 years after reconstruction. Assessments involved the International Knee Documentation Committee (IKDC), Lysholm, and Kujala scores, as well as quadriceps muscle strength and extension lag. Radiologic results were evaluated using the Insall-Salvati index on plain radiography and allograft integration through magnetic resonance imaging. Results: At the final follow-up, the Lysholm, IKDC, and Kujala scores improved by 57, 58, and 54 points, respectively (P<0.001). The average quadriceps muscle strength improved from 2.6 (2 to 3) before the operation to 4.6 (4 to 5) at the final follow-up (P<0.001). The extension lag also improved significantly from 31.7 degrees (25 to 40) to 0.6 degrees (0 to 10). The preoperative Insall-Salvati index was 1.6 (1.5 to 1.9), which improved significantly to 1.2 (1 to 1.3) postoperatively (P<0.001). Two years after the operation, magnetic resonance imaging showed good allograft integration in all pateints. Conclusion: Combining an Achilles tendon-bone allograft with a robust fixation method led to favorable clinical and radiologic outcomes. Level of Evidence: Level IV.
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采用改良固定技术,跟腱-骨同种异体移植治疗慢性髌骨断裂是有利的
目的:髌腱断裂是一种非常致残的伸肌机制损伤。这项随访研究描述了一种用于重建慢性髌骨肌腱断裂的新改良技术的临床和放射学结果。材料与方法:2014 - 2018年,采用同种异体跟腱-骨移植重建慢性髌骨断裂15例。在术前和重建后2 - 7年的最后随访期间评估临床和放射学结果。评估包括国际膝关节文献委员会(IKDC)、Lysholm和Kujala评分,以及股四头肌力量和伸展滞后。放射学结果通过平片的install - salvati指数和磁共振成像的同种异体移植物整合来评估。结果:最终随访时,Lysholm、IKDC和Kujala评分分别提高了57分、58分和54分(P<0.001)。平均股四头肌力量从术前的2.6(2 ~ 3)提高到最终随访时的4.6 (4 ~ 5)(P<0.001)。延伸延迟也从31.7度(25到40)显著改善到0.6度(0到10)。术前install - salvati指数为1.6(1.5 ~ 1.9),术后为1.2(1 ~ 1.3),差异有统计学意义(P<0.001)。术后2年,磁共振成像显示所有患者异体移植物融合良好。结论:将跟腱-骨同种异体移植结合坚固的固定方法可获得良好的临床和影像学结果。证据等级:四级。
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
31
期刊介绍: The purpose of Techniques in Orthopaedics is to provide information on the latest orthopaedic procedure as they are devised and used by top orthopaedic surgeons. The approach is technique-oriented, covering operations, manipulations, and instruments being developed and applied in such as arthroscopy, arthroplasty, and trauma. Each issue is guest-edited by an expert in the field and devoted to a single topic.
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