2024 · Clinics in Orthopedic Surgery
QTPB自家移植腱を用いたACL再建で、部分厚腱と長方形トンネルは円形トンネルより早期の採取部負担を減らせるか？
両群とも安定性と臨床スコアが改善し、術後の群間差は有意ではありませんでした。
対象と方法
絵を読んだ順序です
主な結果
手術に関する読書のポイント
解釈の限界
簡単に説明しましょう
この研究で何が確認されましたか?
両群とも安定性と臨床スコアが改善し、術後の群間差は有意ではありませんでした。
治療決定に直接適用できるか?
後ろ向き短期比較です。長方形は1人、円形は別の2人の術者が選び、採取腱厚も異なるため、術式自体の効果を分離しにくい研究です。短期の有意差なしは長期再断裂リスクの同等性を証明しません。
Keywords・キーワード
- Anterior cruciate ligament
- Anterior cruciate ligament reconstruction
- Quadriceps muscle
- Anterior Cruciate Ligament Reconstruction
- Anterior Cruciate Ligament Injuries
- Autografts
- Retrospective Studies
- Knee Joint
Abstract・原文の抄録
Do Weon Lee, Du Hyun Ro, Myung Chul Lee, Hyuk-Soo Han. 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. Clinics in orthopedic surgery. 2024;16(1):49-56. doi:10.4055/cios21264.
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.
Copyright © 2024 by The Korean Orthopaedic Association
オリジナル紙だ
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
Do Weon Lee, Du Hyun Ro, Myung Chul Lee, Hyuk-Soo Han
Clinics in Orthopedic Surgery · 2024