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Abstract：
OBJECTIVE: The purpose of this study was to evaluate the differences in the patient-reported functional outcomes, and graft failure in revision ACL reconstruction using quadriceps tendon (QT), Hamstring tendon (HT) and bone-patellar tendon-bone (BPTB) autografts.
METHODS: Between 2010 and 2020, 97 patients who underwent revision ACL reconstruction (40 patients received a QT, 26 an HT and 31 a BPTB graft) met the inclusion criteria. Pre-injury and at 2-year postoperatively patients were evaluated for patient-reported functional outcomes; Lysholm knee score, Tegner activity level and VAS (visual analogue scale) for pain; and graft failure. Patient-reported outcomes and graft failure were compared between the QT, HT and BPTB groups. The patients with graft failure were not included for outcome analysis at 2-years of follow-up.
RESULTS: All three revision groups with QT, HT and BPTB autograft did not differ significantly in terms of age, sex, time from injury to surgery, concomitant injuries and single-stage or double-stage procedures (n.s.). No significant difference was found in the pre-injury patient-reported outcome; Lysholm knee score, Tegner activity and VAS for pain (n.s.) between the three groups. At the 2-year follow-up functional outcomes improved in all three groups and all the patients returned to pre-injury activity level; however, no significant difference was found in functional outcomes at the 2-year follow-up between the three groups (n.s.). Graft failure occurred in 4 (10%), 5 (19%) and 3 (10%) patients of QT, HT and BPTB groups, respectively. However, the rate of failure did not differ significantly between groups.
CONCLUSIONS: All three autografts (QT, HT and BPTB) demonstrated satisfactory patient-reported outcomes in revision ACL reconstruction. Compared with QT and BPTB grafts, HT graft showed a higher tendency for failure rates. With the increasing incidence of revision ACL reconstruction, surgeons should be aware of all the available graft options. The findings of this study will assist the surgeons in the graft selection for revision ACL reconstruction.
METHODS: Level III.
METHODS: Between 2010 and 2020, 97 patients who underwent revision ACL reconstruction (40 patients received a QT, 26 an HT and 31 a BPTB graft) met the inclusion criteria. Pre-injury and at 2-year postoperatively patients were evaluated for patient-reported functional outcomes; Lysholm knee score, Tegner activity level and VAS (visual analogue scale) for pain; and graft failure. Patient-reported outcomes and graft failure were compared between the QT, HT and BPTB groups. The patients with graft failure were not included for outcome analysis at 2-years of follow-up.
RESULTS: All three revision groups with QT, HT and BPTB autograft did not differ significantly in terms of age, sex, time from injury to surgery, concomitant injuries and single-stage or double-stage procedures (n.s.). No significant difference was found in the pre-injury patient-reported outcome; Lysholm knee score, Tegner activity and VAS for pain (n.s.) between the three groups. At the 2-year follow-up functional outcomes improved in all three groups and all the patients returned to pre-injury activity level; however, no significant difference was found in functional outcomes at the 2-year follow-up between the three groups (n.s.). Graft failure occurred in 4 (10%), 5 (19%) and 3 (10%) patients of QT, HT and BPTB groups, respectively. However, the rate of failure did not differ significantly between groups.
CONCLUSIONS: All three autografts (QT, HT and BPTB) demonstrated satisfactory patient-reported outcomes in revision ACL reconstruction. Compared with QT and BPTB grafts, HT graft showed a higher tendency for failure rates. With the increasing incidence of revision ACL reconstruction, surgeons should be aware of all the available graft options. The findings of this study will assist the surgeons in the graft selection for revision ACL reconstruction.
METHODS: Level III.
摘要：
目的：本研究的目的是评估患者报告的功能结局的差异，和使用股四头肌腱（QT）的翻修ACL重建中的移植物失败，绳肌腱（HT）和骨-髌腱-骨（BPTB）自体移植物。
方法：在2010年至2020年之间，97例接受了翻修ACL重建的患者（40例患者接受了QT，26aHT和31aBPTB移植物）符合纳入标准。伤前和术后2年评估患者报告的功能结果；Lysholm膝关节评分，疼痛的Tegner活动水平和VAS（视觉模拟量表）；和移植物失败。患者报告的结果和移植物衰竭在QT之间进行比较，HT和BPTB组。在2年的随访中，移植失败的患者未被纳入结果分析。
结果：所有三个QT修订组，HT和BPTB自体移植物在年龄方面没有显著差异，性别,从受伤到手术的时间，伴随损伤和单阶段或双阶段程序（n.s.）。伤前患者报告的结果无显著差异；Lysholm膝关节评分，三组之间的Tegner活性和疼痛VAS（n.s.）。在2年的随访中，所有三组的功能结果都得到了改善，所有患者都恢复到了损伤前的活动水平；然而，在2年随访时,三组间的功能结局无显著差异(n.s.).移植失败发生在4（10％），5例（19%）和3例（10%）患者的QT，HT和BPTB组，分别。然而,两组间的失败率无显著差异.
结论：所有三种自体移植物（QT，HT和BPTB）在翻修ACL重建中显示出令人满意的患者报告结果。与QT和BPTB移植相比，HT移植物显示出更高的失败率趋势。随着ACL翻修重建发生率的增加,外科医生应该知道所有可用的移植物选择。这项研究的结果将有助于外科医生选择移植物以进行翻修ACL重建。
方法：三级。
方法：在2010年至2020年之间，97例接受了翻修ACL重建的患者（40例患者接受了QT，26aHT和31aBPTB移植物）符合纳入标准。伤前和术后2年评估患者报告的功能结果；Lysholm膝关节评分，疼痛的Tegner活动水平和VAS（视觉模拟量表）；和移植物失败。患者报告的结果和移植物衰竭在QT之间进行比较，HT和BPTB组。在2年的随访中，移植失败的患者未被纳入结果分析。
结果：所有三个QT修订组，HT和BPTB自体移植物在年龄方面没有显著差异，性别,从受伤到手术的时间，伴随损伤和单阶段或双阶段程序（n.s.）。伤前患者报告的结果无显著差异；Lysholm膝关节评分，三组之间的Tegner活性和疼痛VAS（n.s.）。在2年的随访中，所有三组的功能结果都得到了改善，所有患者都恢复到了损伤前的活动水平；然而，在2年随访时,三组间的功能结局无显著差异(n.s.).移植失败发生在4（10％），5例（19%）和3例（10%）患者的QT，HT和BPTB组，分别。然而,两组间的失败率无显著差异.
结论：所有三种自体移植物（QT，HT和BPTB）在翻修ACL重建中显示出令人满意的患者报告结果。与QT和BPTB移植相比，HT移植物显示出更高的失败率趋势。随着ACL翻修重建发生率的增加,外科医生应该知道所有可用的移植物选择。这项研究的结果将有助于外科医生选择移植物以进行翻修ACL重建。
方法：三级。
