Do Weon Lee, Du Hyun Ro, Myung Chul Lee, Hyuk-Soo Han
{"title":"使用股四头肌腱-髌骨自体移植物进行矩形隧道式前交叉韧带重建术可降低早期捐献部位的发病率,同时保持可比的短期临床疗效。","authors":"Do Weon Lee, Du Hyun Ro, Myung Chul Lee, Hyuk-Soo Han","doi":"10.4055/cios21264","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Rectangular tunnel and graft have been recently designed to closely resemble the native anatomy in anterior cruciate ligament reconstruction (ACLR). This study was performed to compare the short-term clinical outcomes between rectangular and round femoral tunnels in ACLR using quadriceps tendon-patellar bone (QTPB) autografts.</p><p><strong>Methods: </strong>A total of 78 patients who underwent primary ACLR with QTPB autografts performed by three senior surgeons and had at least 1 year of postoperative follow-up were retrospectively reviewed. Patients who underwent rectangular tunnel ACLR (n = 40) were compared to those treated with the conventional round tunnel ACLR (n = 38). Outcomes including knee stability, clinical scores, quadriceps strength, associated complications, postoperative knee range of motion, and cross-sectional area of the graft were assessed.</p><p><strong>Results: </strong>Significant improvements in knee stability and clinical scores were observed after surgery in both groups (all <i>p</i> < 0.001). The postoperative measurements of knee stability and clinical scores were not significantly different between the two groups. Knee extension strength deficit at 60°/sec was significantly less in the rectangular tunnel group than in the round tunnel group at postoperative 6 months (41.7% vs. 48.9%, <i>p</i> = 0.032). The cross-sectional area of the partial-thickness QTPB graft was approximately 60% of the full-thickness QTPB graft.</p><p><strong>Conclusions: </strong>In the short-term, rectangular tunnel ACLR was comparable to round tunnel ACLR with QTPB autograft despite the smaller cross-sectional area. Additionally, the rectangular tunnel ACLR allowed partial-thickness grafting technique, which could subsequently reduce early donor site morbidity.</p>","PeriodicalId":47648,"journal":{"name":"Clinics in Orthopedic Surgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10825259/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rectangular-Tunnel Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Autograft Can Reduce Early Donor Site Morbidity While Maintaining Comparable Short-term Clinical Outcomes.\",\"authors\":\"Do Weon Lee, Du Hyun Ro, Myung Chul Lee, Hyuk-Soo Han\",\"doi\":\"10.4055/cios21264\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Rectangular tunnel and graft have been recently designed to closely resemble the native anatomy in anterior cruciate ligament reconstruction (ACLR). This study was performed to compare the short-term clinical outcomes between rectangular and round femoral tunnels in ACLR using quadriceps tendon-patellar bone (QTPB) autografts.</p><p><strong>Methods: </strong>A total of 78 patients who underwent primary ACLR with QTPB autografts performed by three senior surgeons and had at least 1 year of postoperative follow-up were retrospectively reviewed. Patients who underwent rectangular tunnel ACLR (n = 40) were compared to those treated with the conventional round tunnel ACLR (n = 38). Outcomes including knee stability, clinical scores, quadriceps strength, associated complications, postoperative knee range of motion, and cross-sectional area of the graft were assessed.</p><p><strong>Results: </strong>Significant improvements in knee stability and clinical scores were observed after surgery in both groups (all <i>p</i> < 0.001). The postoperative measurements of knee stability and clinical scores were not significantly different between the two groups. Knee extension strength deficit at 60°/sec was significantly less in the rectangular tunnel group than in the round tunnel group at postoperative 6 months (41.7% vs. 48.9%, <i>p</i> = 0.032). The cross-sectional area of the partial-thickness QTPB graft was approximately 60% of the full-thickness QTPB graft.</p><p><strong>Conclusions: </strong>In the short-term, rectangular tunnel ACLR was comparable to round tunnel ACLR with QTPB autograft despite the smaller cross-sectional area. Additionally, the rectangular tunnel ACLR allowed partial-thickness grafting technique, which could subsequently reduce early donor site morbidity.</p>\",\"PeriodicalId\":47648,\"journal\":{\"name\":\"Clinics in Orthopedic Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10825259/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinics in Orthopedic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4055/cios21264\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinics in Orthopedic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4055/cios21264","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Rectangular-Tunnel Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Autograft Can Reduce Early Donor Site Morbidity While Maintaining Comparable Short-term Clinical Outcomes.
Background: Rectangular tunnel and graft have been recently designed to closely resemble the native anatomy in anterior cruciate ligament reconstruction (ACLR). This study was performed to compare the short-term clinical outcomes between rectangular and round femoral tunnels in ACLR using quadriceps tendon-patellar bone (QTPB) autografts.
Methods: A total of 78 patients who underwent primary ACLR with QTPB autografts performed by three senior surgeons and had at least 1 year of postoperative follow-up were retrospectively reviewed. Patients who underwent rectangular tunnel ACLR (n = 40) were compared to those treated with the conventional round tunnel ACLR (n = 38). Outcomes including knee stability, clinical scores, quadriceps strength, associated complications, postoperative knee range of motion, and cross-sectional area of the graft were assessed.
Results: Significant improvements in knee stability and clinical scores were observed after surgery in both groups (all p < 0.001). The postoperative measurements of knee stability and clinical scores were not significantly different between the two groups. Knee extension strength deficit at 60°/sec was significantly less in the rectangular tunnel group than in the round tunnel group at postoperative 6 months (41.7% vs. 48.9%, p = 0.032). The cross-sectional area of the partial-thickness QTPB graft was approximately 60% of the full-thickness QTPB graft.
Conclusions: In the short-term, rectangular tunnel ACLR was comparable to round tunnel ACLR with QTPB autograft despite the smaller cross-sectional area. Additionally, the rectangular tunnel ACLR allowed partial-thickness grafting technique, which could subsequently reduce early donor site morbidity.