PDF(Pubmed)
Abstract：
OBJECTIVE: Peroneus Longus Tendon (PLT), a viable anterior cruciate ligament (ACL) graft, shares similar biomechanics, making it suitable for reconstruction. Controversy exists over whether PLT transplants affects the donor ankle joint. The purpose of this study was to examine the recovery of knee joint function following arthroscopic ACL restoration using autologous PLT and its influence on the donor ankle joint.
METHODS: A retrospective analysis was conducted on 65 patients with ACL rupture who underwent PLT graft reconstruction in our hospital from January 2016 to December 2021. A three-dimensional gait analysis of the bilateral knee and ankle joints was performed postoperatively using an Opti_Knee three-dimensional motion measurement and analysis system-Yidong Medical Infrared Motion Gait Analyzer. Knee function scores and changes in the range of motion of the bilateral knee and ankle joints were collected. The analysis of preoperative and postoperative joint function scores, bilateral knee and ankle mobility was performed by t-tests.
RESULTS: One year after surgery, the patients\' International Knee Documentation Committee (IKDC) scores, Knee Injury and Osteoarthritis Outcome Scores (KOOSs), and Lysholm scores were significantly improved compared to preoperative scores, with statistically significant differences (p < 0.05). There was no statistical difference in the American Orthopedic Foot and Ankle Society (AOFAS) score of the donor ankle joint before and after surgery (p > 0.05). During different gait cycles, there was no statistical difference in knee joint mobility between the affected and healthy sides (p > 0.05), but there was a statistical difference in the inversion and eversion angle of the donor ankle joint during the support phase (p < 0.05).
CONCLUSIONS: ACL reconstruction using the PLT can yield satisfactory knee joint function. However, it does affect inversion and eversion in the donor ankle joint, necessitating postoperative exercises. Similar subjective function ratings for both operated and non-operated feet, despite increased inversion-eversion motion in the operated foot, may be influenced by the subjective nature and margin of error in the AOFAS Ankle-hindfoot score, along with the relatively small variation in ankle inversion-eversion angles.
METHODS: A retrospective analysis was conducted on 65 patients with ACL rupture who underwent PLT graft reconstruction in our hospital from January 2016 to December 2021. A three-dimensional gait analysis of the bilateral knee and ankle joints was performed postoperatively using an Opti_Knee three-dimensional motion measurement and analysis system-Yidong Medical Infrared Motion Gait Analyzer. Knee function scores and changes in the range of motion of the bilateral knee and ankle joints were collected. The analysis of preoperative and postoperative joint function scores, bilateral knee and ankle mobility was performed by t-tests.
RESULTS: One year after surgery, the patients\' International Knee Documentation Committee (IKDC) scores, Knee Injury and Osteoarthritis Outcome Scores (KOOSs), and Lysholm scores were significantly improved compared to preoperative scores, with statistically significant differences (p < 0.05). There was no statistical difference in the American Orthopedic Foot and Ankle Society (AOFAS) score of the donor ankle joint before and after surgery (p > 0.05). During different gait cycles, there was no statistical difference in knee joint mobility between the affected and healthy sides (p > 0.05), but there was a statistical difference in the inversion and eversion angle of the donor ankle joint during the support phase (p < 0.05).
CONCLUSIONS: ACL reconstruction using the PLT can yield satisfactory knee joint function. However, it does affect inversion and eversion in the donor ankle joint, necessitating postoperative exercises. Similar subjective function ratings for both operated and non-operated feet, despite increased inversion-eversion motion in the operated foot, may be influenced by the subjective nature and margin of error in the AOFAS Ankle-hindfoot score, along with the relatively small variation in ankle inversion-eversion angles.
摘要：
目标：腓骨长肌腱（PLT），可行的前交叉韧带（ACL）移植物，拥有相似的生物力学，使其适合重建。关于PLT移植是否影响供体踝关节存在争议。这项研究的目的是检查使用自体PLT进行关节镜ACL修复后膝关节功能的恢复及其对供体踝关节的影响。
方法：回顾性分析2016年1月至2021年12月在我院行PLT移植重建的65例ACL断裂患者的临床资料。术后采用Opti_Knee三维运动测量分析系统-益东医用红外运动步态分析仪对双侧膝关节和踝关节进行三维步态分析。收集膝关节功能评分以及双侧膝关节和踝关节活动范围的变化。术前、术后关节功能评分分析,双侧膝关节和踝关节活动度采用t检验.
结果：手术后一年，患者国际膝关节文献委员会(IKDC)评分，膝关节损伤和骨关节炎结果评分（KOOS），Lysholm评分较术前评分显著提高，差异具有统计学意义(p<0.05)。供体踝关节手术前后美国骨科足踝协会(AOFAS)评分无统计学差异(p>0.05)。在不同的步态周期中，患侧和健康侧膝关节活动度无统计学差异(p>0.05),但在支撑阶段供体踝关节的内翻和外翻角度存在统计学差异(p<0.05)。
结论：使用PLT重建ACL可以获得满意的膝关节功能。然而,它确实会影响供体踝关节的内翻和外翻，需要术后锻炼。手术和非手术脚的主观功能评分相似，尽管手术脚的内翻-外翻运动增加，可能会受到AOFAS脚踝后足评分的主观性质和误差幅度的影响，随着踝关节内翻-外翻角度的变化相对较小。
方法：回顾性分析2016年1月至2021年12月在我院行PLT移植重建的65例ACL断裂患者的临床资料。术后采用Opti_Knee三维运动测量分析系统-益东医用红外运动步态分析仪对双侧膝关节和踝关节进行三维步态分析。收集膝关节功能评分以及双侧膝关节和踝关节活动范围的变化。术前、术后关节功能评分分析,双侧膝关节和踝关节活动度采用t检验.
结果：手术后一年，患者国际膝关节文献委员会(IKDC)评分，膝关节损伤和骨关节炎结果评分（KOOS），Lysholm评分较术前评分显著提高，差异具有统计学意义(p<0.05)。供体踝关节手术前后美国骨科足踝协会(AOFAS)评分无统计学差异(p>0.05)。在不同的步态周期中，患侧和健康侧膝关节活动度无统计学差异(p>0.05),但在支撑阶段供体踝关节的内翻和外翻角度存在统计学差异(p<0.05)。
结论：使用PLT重建ACL可以获得满意的膝关节功能。然而,它确实会影响供体踝关节的内翻和外翻，需要术后锻炼。手术和非手术脚的主观功能评分相似，尽管手术脚的内翻-外翻运动增加，可能会受到AOFAS脚踝后足评分的主观性质和误差幅度的影响，随着踝关节内翻-外翻角度的变化相对较小。
