Comparison of “ligamentization” process between preserved insertion hamstring tendon autograft and bone-patellar tendon-bone autograft

IF 1.5 4区医学 Q3 ORTHOPEDICS Journal of Orthopaedic Science Pub Date : 2024-07-01 DOI:10.1016/j.jos.2023.06.014

Ravi Gupta , Sandeep Singh , Anil Kapoor , Ashwani Soni , Rohil Mehta , Ravinder Kaur , Gladson David Masih

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Abstract

Background

Ligamentization is a complex process and effect of preservation of hamstring tendon graft insertion on this process is not well studied. Present study was conducted to analyze and compare the ligamentization of semitendinosus gracilis graft with preserved tibial insertion (STGPI) and bone-patellar tendon-bone (BPTB) autografts.

Methods

A total of 50 sportspeople who underwent ACL reconstruction using either BPTB (group A; n = 25) or STGPI (group B; n = 25) autografts were included in the study. Contrast enhanced MRI was done at 8 months and 14 months post-ACL reconstruction to evaluate the ligamentization using Signal noise quotient (SNQ), graft intensity and enhancement index. Clinical outcomes (Lysholm score) and knee laxity were also assessed at 8 months and 14 months.

Results

18/23 (78%) patients in group A and 14/23 (61%) patients in group B had hyperintense graft signal at 8 months (n.s.) and at 14 months, 1/23 patients in group A and none of the patients in group B had hyperintense graft. SNQ at 8 months was 3.6 ± 2 and 3.7 ± 2 in group A and B respectively (n.s.) and at 14 months, SNQ was 2.5 ± 1.5 in group A and 2.4 ± 1.3 in group B (n.s.). Enhancement index at 8 months was 1.5 ± 0.3 and 1.2 ± 0.3 in group A and B respectively (p = 0.0001). Enhancement index at 14 months was 1.21 ± 0.2 in group A and 1.07 ± 0.2 in group B (p = 0.003). Functional outcomes and knee laxity were comparable in both the groups at 8 and 14 months (n.s.).

Conclusion

Both the grafts i.e. BPTB and STGPI are similar in terms of rate and extent of ligamentization. Clinical outcomes and knee laxity are also comparable between two grafts.

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比较保留插入腘绳肌腱自体移植物和骨-髌腱-骨自体移植物的 "韧带化 "过程。

背景：结扎是一个复杂的过程，而保留腘绳肌腱移植物插入部对这一过程的影响尚未得到充分研究。本研究旨在分析和比较保留胫骨插入部的半腱肌移植物（STGPI）和骨-髌腱-骨（BPTB）自体移植物的结扎情况：共有 50 名运动员接受了前交叉韧带重建术，他们使用了 BPTB（A 组，n = 25）或 STGPI（B 组，n = 25）自体移植物。在前交叉韧带重建后 8 个月和 14 个月时进行对比增强核磁共振成像，利用信号噪声商（SNQ）、移植物强度和增强指数评估韧带韧化情况。在8个月和14个月时，还对临床结果（Lysholm评分）和膝关节松弛情况进行了评估：结果：8 个月时，18/23（78%）名 A 组患者和 14/23（61%）名 B 组患者出现移植物高密度信号（n.s.）；14 个月时，1/23（1/23）名 A 组患者和 0 名 B 组患者出现移植物高密度信号。8 个月时，A 组和 B 组的 SNQ 分别为 3.6 ± 2 和 3.7 ± 2（正常值）；14 个月时，A 组的 SNQ 为 2.5 ± 1.5，B 组为 2.4 ± 1.3（正常值）。8 个月时，A 组和 B 组的增强指数分别为 1.5 ± 0.3 和 1.2 ± 0.3（p = 0.0001）。14 个月时，A 组的增强指数为 1.21 ± 0.2，B 组为 1.07 ± 0.2（p = 0.003）。两组在 8 个月和 14 个月时的功能结果和膝关节松弛程度相当（n.s.）：结论：BPTB 和 STGPI 两种移植物的结扎率和程度相似。结论：BPTB 和 STGPI 两种移植物的结扎率和结扎程度相似，临床效果和膝关节松弛程度也相当。

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来源期刊

Journal of Orthopaedic Science 医学-整形外科

CiteScore

3.00

自引率

0.00%

发文量

290

审稿时长

90 days

期刊介绍： The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.