Pierre-Alban Bouché , Nicolas Lefevre , Yoann Bohu , Antoine Gerometta , Alain Meyer , Olivier Grimaud , Alexandre Hardy
{"title":"前交叉韧带重建术后 2 年带锁螺钉短移植系统与 STG 技术再撕裂率的比较:一项采用倾向评分匹配的病例对照研究。","authors":"Pierre-Alban Bouché , Nicolas Lefevre , Yoann Bohu , Antoine Gerometta , Alain Meyer , Olivier Grimaud , Alexandre Hardy","doi":"10.1016/j.otsr.2024.103848","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>Theoretically, short semitendinosus grafts result in less pain and morbidity while providing greater knee flexion strength and sparing the gracilis tendon. They often require the use of blind bone tunnels as well as fixation at both ends of the graft with suspensory cortical buttons. The “Tape Locking Screw” (TLS) system is another option. There are few studies comparing ACL reconstruction with a short graft using the 4-strand semitendinosus graft (ST4-TLS) technique with that of the semitendinosus-gracilis (STG) procedure. This study was designed: (1) to compare the retear rate following these two technics after 2<!--> <!-->years of follow-up, (2) to compare the clinical scores, complications and return to sport times between the two procedures Q1, Q2.</p></div><div><h3>Hypothesis</h3><p>Our hypothesis was that there would be no differences in retear rates between the two techniques.</p></div><div><h3>Methods</h3><p>This single center case control study included 290 patients who underwent STG reconstruction that were paired by propensity score matching to 299 patients who underwent ST4-TLS reconstruction. The main evaluation criterion was the retear rate 2<!--> <!-->years after surgery. Secondary criteria were the two-year postoperative complication rate, the time to return to sport, to pivot sports and to running, as well as the complication rates and clinical scores 6<!--> <!-->months, 1<!--> <!-->year and 2<!--> <!-->years after surgery.</p></div><div><h3>Results</h3><p>At the final follow-up, the overall retear rate in our series of ACL ligament reconstruction was 6.0% (36/596). There was no difference in retear rates between the groups 2<!--> <!-->years after ligament reconstruction [ST4-TLS: 6.7% (20/299) vs. STG: 5.4% (16/297); <em>p</em> <!-->=<!--> <!-->0.47]. The postoperative KOOS symptom score and the Tegner score were found to be better in the STG group at 1<!--> <!-->year (81 vs. 78, <em>p</em> <!-->=<!--> <!-->0.008) and 2<!--> <!-->years (5.64 vs. 5.10, <em>p</em> <!-->=<!--> <!-->0.016), respectively, representing the minimally clinically important difference (MCID) for the latter. No difference was found in the other clinical scores 6<!--> <!-->months, 1<!--> <!-->year or 2<!--> <!-->years after surgery. There was no significant difference in the return to sport [TLS: 93.0% (164/299) vs. STG: 93.0% (158/297) <em>p</em> <!-->=<!--> <!-->0.99] or the complication rate [TLS: 8.7% (26/299) vs. STG: 7.4% (22/297) <em>p</em> <!-->=<!--> <!-->0.89] between the groups.</p></div><div><h3>Discussion</h3><p>The ST4-TLS ACL ligament reconstruction technique was found to be as reliable as the standard STG procedure 2<!--> <!-->years after surgery for the retear rate and the return to sport, although the results of certain postoperative clinical scores seem to be lower.</p></div><div><h3>Level of evidence</h3><p>III; case control study.</p></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of the retear rate 2 years after ACL reconstruction with the Tape Locking Screw short graft system and the STG technique: A case control study with propensity score matching\",\"authors\":\"Pierre-Alban Bouché , Nicolas Lefevre , Yoann Bohu , Antoine Gerometta , Alain Meyer , Olivier Grimaud , Alexandre Hardy\",\"doi\":\"10.1016/j.otsr.2024.103848\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>Theoretically, short semitendinosus grafts result in less pain and morbidity while providing greater knee flexion strength and sparing the gracilis tendon. They often require the use of blind bone tunnels as well as fixation at both ends of the graft with suspensory cortical buttons. The “Tape Locking Screw” (TLS) system is another option. There are few studies comparing ACL reconstruction with a short graft using the 4-strand semitendinosus graft (ST4-TLS) technique with that of the semitendinosus-gracilis (STG) procedure. This study was designed: (1) to compare the retear rate following these two technics after 2<!--> <!-->years of follow-up, (2) to compare the clinical scores, complications and return to sport times between the two procedures Q1, Q2.</p></div><div><h3>Hypothesis</h3><p>Our hypothesis was that there would be no differences in retear rates between the two techniques.</p></div><div><h3>Methods</h3><p>This single center case control study included 290 patients who underwent STG reconstruction that were paired by propensity score matching to 299 patients who underwent ST4-TLS reconstruction. The main evaluation criterion was the retear rate 2<!--> <!-->years after surgery. Secondary criteria were the two-year postoperative complication rate, the time to return to sport, to pivot sports and to running, as well as the complication rates and clinical scores 6<!--> <!-->months, 1<!--> <!-->year and 2<!--> <!-->years after surgery.</p></div><div><h3>Results</h3><p>At the final follow-up, the overall retear rate in our series of ACL ligament reconstruction was 6.0% (36/596). There was no difference in retear rates between the groups 2<!--> <!-->years after ligament reconstruction [ST4-TLS: 6.7% (20/299) vs. STG: 5.4% (16/297); <em>p</em> <!-->=<!--> <!-->0.47]. The postoperative KOOS symptom score and the Tegner score were found to be better in the STG group at 1<!--> <!-->year (81 vs. 78, <em>p</em> <!-->=<!--> <!-->0.008) and 2<!--> <!-->years (5.64 vs. 5.10, <em>p</em> <!-->=<!--> <!-->0.016), respectively, representing the minimally clinically important difference (MCID) for the latter. No difference was found in the other clinical scores 6<!--> <!-->months, 1<!--> <!-->year or 2<!--> <!-->years after surgery. There was no significant difference in the return to sport [TLS: 93.0% (164/299) vs. STG: 93.0% (158/297) <em>p</em> <!-->=<!--> <!-->0.99] or the complication rate [TLS: 8.7% (26/299) vs. STG: 7.4% (22/297) <em>p</em> <!-->=<!--> <!-->0.89] between the groups.</p></div><div><h3>Discussion</h3><p>The ST4-TLS ACL ligament reconstruction technique was found to be as reliable as the standard STG procedure 2<!--> <!-->years after surgery for the retear rate and the return to sport, although the results of certain postoperative clinical scores seem to be lower.</p></div><div><h3>Level of evidence</h3><p>III; case control study.</p></div>\",\"PeriodicalId\":54664,\"journal\":{\"name\":\"Orthopaedics & Traumatology-Surgery & Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Orthopaedics & Traumatology-Surgery & Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1877056824000562\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopaedics & Traumatology-Surgery & Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1877056824000562","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的:从理论上讲,短半腱肌移植物可减少疼痛和发病率,同时提供更大的膝关节屈曲力量,并保留擒拿肌腱。这种方法通常需要使用骨盲道,并在移植物的两端使用悬吊皮质扣进行固定。带锁螺钉(TLS)系统是另一种选择。目前很少有研究比较使用四股半腱肌移植物(ST4-TLS)技术和半腱肌-racilis(STG)术进行前交叉韧带重建。本研究的目的是:1)比较两种技术在两年随访后的再撕裂率;2)比较两种手术的临床评分、并发症和恢复运动时间:我们的假设是,两种技术的再撕裂率没有差异:这项单中心病例对照研究包括 290 名接受 STG 重建术的患者,他们与 299 名接受 ST4-TLS 重建术的患者通过倾向评分配对。主要评估标准是术后两年的再撕裂率。次要标准是术后两年的并发症发生率,恢复运动、枢轴运动和跑步的时间,以及术后6个月、1年和2年的并发症发生率和临床评分:在最后的随访中,我们的前交叉韧带重建系列手术的总体再撕裂率为6.0%(36/596)。韧带重建 2 年后,两组的再撕裂率没有差异(ST4-TLS:6.7% (20/299) vs STG:5.4% (16/297);P=0.47)。STG组的术后KOOS症状评分和Tegner评分在1年(81分 vs 78分,P= 0.008)和2年(5.64分 vs 5.10分,P=0.016)时分别优于ST4组和STG组,后者达到了最小临床意义差异(MCID)。术后6个月、1年或2年的其他临床评分均无差异。两组患者的运动恢复率(TLS:93.0% (164/299) vs STG:93.0% (158/297) p=0.99)和并发症发生率(TLS:8.7% (26/299) vs STG:7.4% (22/297) p=0.89)无明显差异:讨论:ST4-TLS前交叉韧带重建技术在术后2年的再撕裂率和恢复运动方面与标准STG手术一样可靠,尽管术后某些临床评分结果似乎较低:证据等级:III;病例对照研究。
Comparison of the retear rate 2 years after ACL reconstruction with the Tape Locking Screw short graft system and the STG technique: A case control study with propensity score matching
Purpose
Theoretically, short semitendinosus grafts result in less pain and morbidity while providing greater knee flexion strength and sparing the gracilis tendon. They often require the use of blind bone tunnels as well as fixation at both ends of the graft with suspensory cortical buttons. The “Tape Locking Screw” (TLS) system is another option. There are few studies comparing ACL reconstruction with a short graft using the 4-strand semitendinosus graft (ST4-TLS) technique with that of the semitendinosus-gracilis (STG) procedure. This study was designed: (1) to compare the retear rate following these two technics after 2 years of follow-up, (2) to compare the clinical scores, complications and return to sport times between the two procedures Q1, Q2.
Hypothesis
Our hypothesis was that there would be no differences in retear rates between the two techniques.
Methods
This single center case control study included 290 patients who underwent STG reconstruction that were paired by propensity score matching to 299 patients who underwent ST4-TLS reconstruction. The main evaluation criterion was the retear rate 2 years after surgery. Secondary criteria were the two-year postoperative complication rate, the time to return to sport, to pivot sports and to running, as well as the complication rates and clinical scores 6 months, 1 year and 2 years after surgery.
Results
At the final follow-up, the overall retear rate in our series of ACL ligament reconstruction was 6.0% (36/596). There was no difference in retear rates between the groups 2 years after ligament reconstruction [ST4-TLS: 6.7% (20/299) vs. STG: 5.4% (16/297); p = 0.47]. The postoperative KOOS symptom score and the Tegner score were found to be better in the STG group at 1 year (81 vs. 78, p = 0.008) and 2 years (5.64 vs. 5.10, p = 0.016), respectively, representing the minimally clinically important difference (MCID) for the latter. No difference was found in the other clinical scores 6 months, 1 year or 2 years after surgery. There was no significant difference in the return to sport [TLS: 93.0% (164/299) vs. STG: 93.0% (158/297) p = 0.99] or the complication rate [TLS: 8.7% (26/299) vs. STG: 7.4% (22/297) p = 0.89] between the groups.
Discussion
The ST4-TLS ACL ligament reconstruction technique was found to be as reliable as the standard STG procedure 2 years after surgery for the retear rate and the return to sport, although the results of certain postoperative clinical scores seem to be lower.
期刊介绍:
Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.