缝合带增强前交叉韧带急性近端撕脱修复术与使用腘绳肌自体移植物的前交叉韧带重建术在年轻、活跃人群中的松弛、本体感觉和神经肌肉控制方面没有差异

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2024-09-26 DOI:10.1002/jeo2.70025

Adrian Góralczyk, Paulina Zalewska, Szczepan Piszczatowski, Krzysztof Hermanowicz, Tomasz Guszczyn

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摘要

目的本研究旨在比较缝合带增强前交叉韧带（ACL）修复术（内支撑[IB]）和使用腘绳肌自体移植物的 ACL 重建术（ACLR）在松弛、本体感觉和神经肌肉控制方面的效果。假设在严格的适应症下，IB 可在本体感觉和神经肌肉控制方面提供更好的效果。方法在这项回顾性研究中，纳入了接受 IB 或用腘绳肌自体移植进行 ACLR 治疗的单侧 ACL 损伤患者。使用Rolimeter测量屈曲30°和90°时的胫骨前平移（ATT）。关节位置感（JPS）测试使用 Biodex System 4Pro 在屈曲 30° 和 60° 时进行。在动态任务中使用时间同步运动捕捉系统和表面肌电图组评估膝关节外翻、半腱肌（ST）和股二头肌（BF）活动。对两种技术以及手术膝关节与对侧健康膝关节进行了比较。结果研究组包括 28 名 ACLR 患者（21.8 ± 4.8 岁）和 20 名 IB 患者（25.8 ± 10.5 岁），平均随访时间分别为 30 ± 18 个月和 28 ± 15 个月。手术组之间的 ATT 没有明显差异。前交叉韧带置换术后膝关节屈曲30°时的ATT明显高于对侧膝关节（5.8 ± 2.4 mm vs. 4.3 ± 1.3 mm, p < 0.001）。JPS测试和膝关节动态外翻无明显差异。在动态任务中，前交叉韧带重建组的 ST（p = 0.048）和 BF（p = 0.012）活动明显高于手术组和对侧膝关节。结论在松弛、本体感觉和神经肌肉控制方面，缝合带增强前交叉韧带修复术和腘绳肌自体移植前交叉韧带重建术的效果相似。证据等级 III 级：回顾性比较研究。

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No difference in laxity, proprioception and neuromuscular control after suture-tape augmented ACL repair of acute proximal avulsions versus ACL reconstruction using hamstring autografts in young, active population

Purpose

The purpose of this study is to compare results of suture-tape augmented anterior cruciate ligament (ACL) repair (internal bracing [IB]) and ACL reconstruction (ACLR) with hamstring autograft in terms of laxity, proprioception and neuromuscular control. The hypothesis was that with strict indications IB may provide better results in proprioception and neuromuscular control.

Methods

Patients with unilateral ACL injury treated with IB or ACLR with hamstring autograft were enroled in this retrospective study. Anterior tibial translation (ATT) in 30° and 90° of flexion was measured with Rolimeter. The joint position sense (JPS) test was performed in 30° and 60° of flexion using Biodex System 4Pro. The time-synchronized motion capture system and surface electromyography set were used during dynamic tasks to assess knee valgus and semitendinosus (ST) and biceps femoris (BF) activities. Comparisons between both techniques and operated versus contralateral healthy knees were performed.

Results

The study groups involved 28 patients after ACLR (21.8 ± 4.8 years) and 20 patients after IB (25.8 ± 10.5 years) with the average follow-up 30 ± 18 and 28 ± 15 months, respectively. The ATT did not differ significantly between operated groups. In 30° of flexion ATT for ACLR was significantly higher in operated than in contralateral knee (5.8 ± 2.4 mm vs. 4.3 ± 1.3 mm, p < 0.001). The JPS test and dynamic knee valgus presented no significant differences. The ACLR group presented significantly higher ST (p = 0.048) and BF (p = 0.012) activity comparing operated to contralateral knee in dynamic tasks.

Conclusion

Suture-tape augmented ACL repair and ACLR with hamstring autograft yield similar results in terms of laxity, proprioception and neuromuscular control.