PDF(Pubmed)
Abstract：
UNASSIGNED: Single-bundle anterior cruciate ligament reconstruction (SB-ACLR) with concomitant anterolateral ligament reconstruction (ALLR) has been associated with better clinical results when compared with isolated SB-ACLR. However, it is not known whether the improved outcomes are the result of the influence of concomitant ALLR on ACL graft healing.
UNASSIGNED: The purpose of this study was to determine whether concomitant ALLR is associated with improved graft ligamentization after SB-ACLR. It was hypothesized that ALLR would not affect graft healing.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A 1 to 1 matching study was conducted on a consecutive series of 732 patients who underwent ACLR using a hamstring tendon autograft between 2007 and 2019. Patients were excluded if they had skeletal immaturity, inflammatory joint disease, multiple ligament reconstruction (other than ALLR), or a graft rupture. Patients with concomitant SB-ACLR and ALLR (SB-ACLR/ALLR) and isolated SB-ACLR were matched 1 to 1 based on age, sex, examination under anesthesia (EUA) grade 3 pivot shift, EUA grade 3 anterior drawer test, presence of graft impingement, sagittal graft angle, skeletal maturity, lack of generalized ligamentous laxity, and multiple ligamentous injury. A total of 40 matched pairs underwent postoperative magnetic resonance imaging (MRI) within the second year after surgery to assess graft ligamentization, which was measured by the signal-to-noise quotient (SNQ) of the ACL graft.
UNASSIGNED: The mean follow-up period was 41 months, with a 2-year follow-up rate of 80% in the SB-ACLR/ALLR group and 98% in the isolated SB-ACLR group. The mean duration between the index operation and MRI was 16.4 ± 3.4 months. No significant difference was observed in the SNQ of the ACL graft between the SB-ACLR/ALLR and SB-ACLR groups (6.9 ± 4.6 vs 5.2 ± 4.8, respectively; P = .066).
UNASSIGNED: Study findings indicated that a concomitant ALLR at the time of hamstring tendon autograft ACLR did not affect graft healing as assessed by the SNQ of the ACL graft.
UNASSIGNED: The purpose of this study was to determine whether concomitant ALLR is associated with improved graft ligamentization after SB-ACLR. It was hypothesized that ALLR would not affect graft healing.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A 1 to 1 matching study was conducted on a consecutive series of 732 patients who underwent ACLR using a hamstring tendon autograft between 2007 and 2019. Patients were excluded if they had skeletal immaturity, inflammatory joint disease, multiple ligament reconstruction (other than ALLR), or a graft rupture. Patients with concomitant SB-ACLR and ALLR (SB-ACLR/ALLR) and isolated SB-ACLR were matched 1 to 1 based on age, sex, examination under anesthesia (EUA) grade 3 pivot shift, EUA grade 3 anterior drawer test, presence of graft impingement, sagittal graft angle, skeletal maturity, lack of generalized ligamentous laxity, and multiple ligamentous injury. A total of 40 matched pairs underwent postoperative magnetic resonance imaging (MRI) within the second year after surgery to assess graft ligamentization, which was measured by the signal-to-noise quotient (SNQ) of the ACL graft.
UNASSIGNED: The mean follow-up period was 41 months, with a 2-year follow-up rate of 80% in the SB-ACLR/ALLR group and 98% in the isolated SB-ACLR group. The mean duration between the index operation and MRI was 16.4 ± 3.4 months. No significant difference was observed in the SNQ of the ACL graft between the SB-ACLR/ALLR and SB-ACLR groups (6.9 ± 4.6 vs 5.2 ± 4.8, respectively; P = .066).
UNASSIGNED: Study findings indicated that a concomitant ALLR at the time of hamstring tendon autograft ACLR did not affect graft healing as assessed by the SNQ of the ACL graft.
摘要：
■与单独的SB-ACLR相比，单束前交叉韧带重建（SB-ACLR）与前外侧韧带重建（ALLR）具有更好的临床效果。然而,目前尚不清楚预后的改善是否是伴随ALLR对ACL移植物愈合影响的结果.
■这项研究的目的是确定伴随的ALLR是否与SB-ACLR后的移植物韧带化改善有关。假设ALLR不会影响移植物愈合。
■队列研究；证据水平，3.
■在2007年至2019年期间，对连续的732名患者进行了1至1匹配研究，这些患者在接受ACLR时使用了绳肌腱自体移植物。如果患者骨骼不成熟，将被排除在外，炎症性关节病，多韧带重建（ALLR除外），或移植物破裂。伴随SB-ACLR和ALLR（SB-ACLR/ALLR）和孤立的SB-ACLR患者根据年龄1-1匹配。性别,麻醉下检查（EUA）3级枢轴移位，EUA3级前抽屉测试，移植物撞击的存在，矢状移植物角度,骨骼成熟度,缺乏全身韧带松弛，和多处韧带损伤。共有40对配对的患者在手术后第二年内接受了术后磁共振成像（MRI），以评估移植物韧带化，通过ACL移植物的信噪比（SNQ）测量。
■平均随访时间为41个月，SB-ACLR/ALLR组的2年随访率为80％，孤立的SB-ACLR组为98％。索引手术和MRI之间的平均持续时间为16.4±3.4个月。SB-ACLR/ALLR和SB-ACLR组之间的ACL移植物SNQ没有显着差异（分别为6.9±4.6和5.2±4.8；P=.066）。
■研究结果表明，如通过ACL移植物的SNQ评估，自体肌腱移植时伴随的ALLR不影响移植物愈合。
■这项研究的目的是确定伴随的ALLR是否与SB-ACLR后的移植物韧带化改善有关。假设ALLR不会影响移植物愈合。
■队列研究；证据水平，3.
■在2007年至2019年期间，对连续的732名患者进行了1至1匹配研究，这些患者在接受ACLR时使用了绳肌腱自体移植物。如果患者骨骼不成熟，将被排除在外，炎症性关节病，多韧带重建（ALLR除外），或移植物破裂。伴随SB-ACLR和ALLR（SB-ACLR/ALLR）和孤立的SB-ACLR患者根据年龄1-1匹配。性别,麻醉下检查（EUA）3级枢轴移位，EUA3级前抽屉测试，移植物撞击的存在，矢状移植物角度,骨骼成熟度,缺乏全身韧带松弛，和多处韧带损伤。共有40对配对的患者在手术后第二年内接受了术后磁共振成像（MRI），以评估移植物韧带化，通过ACL移植物的信噪比（SNQ）测量。
■平均随访时间为41个月，SB-ACLR/ALLR组的2年随访率为80％，孤立的SB-ACLR组为98％。索引手术和MRI之间的平均持续时间为16.4±3.4个月。SB-ACLR/ALLR和SB-ACLR组之间的ACL移植物SNQ没有显着差异（分别为6.9±4.6和5.2±4.8；P=.066）。
■研究结果表明，如通过ACL移植物的SNQ评估，自体肌腱移植时伴随的ALLR不影响移植物愈合。
