PDF(Pubmed)
Abstract：
BACKGROUND: The periosteum is a readily available tissue at the hamstring harvest site that could be utilized to enhance graft healing and prevent tunnel widening without additional cost or morbidity. This study aimed to compare graft healing using magnetic resonance imaging (MRI) and functional clinical outcome scores in a matched cohort of patients who underwent anterior cruciate ligament (ACL) reconstruction with hamstring autografts with or without periosteal augmentation.
METHODS: Forty-eight patients who underwent ACL reconstruction (ACLR) were prospectively enrolled: 25 with standard ACLR (ST-ACLR) and 23 with periosteal augmented grafts (PA-ACLR). The same surgical techniques, fixation methods, and postoperative protocol were used in both groups. Signal-to-noise quotient (SNQ), graft healing at the bone-graft interface, graft signal according to the Howell scale, and femoral tunnel widening were evaluated using MRI after 1 year of follow-up. International knee documentation score (IKDC), Lysholm, Tegner activity scale, and visual analog scale for pain were used for functional evaluation at a minimum of 2 years postoperative.
RESULTS: The mean SNQ of the proximal part of the graft was 9.6 ± 9.2 and 2.9 ± 3.3 for the ST-ACLR and PA-ACLR groups, respectively (P = 0.005). The mean femoral tunnel widening was 30.3% ± 18.3 and 2.3% ± 9.9 for the ST-ACLR, PA-ACLR groups, respectively (P < 0.001). Complete graft tunnel healing was observed in 65% and 28% of cases in the PA-ACLR and ST-ACLR groups, respectively. Both groups showed marked improvements in functional scores, with no statistically significant differences.
CONCLUSIONS: Periosteal wrapping of hamstring tendon autografts is associated with better graft healing and maturation and lower incidence of femoral tunnel widening based on MRI analysis 1 year after ACL reconstruction. However, patient-reported outcomes and measured laxity were similar between the two groups at 2 years follow up.
BACKGROUND: Trail registration number: PACTR202308594339018, date of registration: 1/5/2023, retrospectively registered at the Pan African Clinical Trial Registry (pactr.samrc.ac.za) database.
METHODS: Forty-eight patients who underwent ACL reconstruction (ACLR) were prospectively enrolled: 25 with standard ACLR (ST-ACLR) and 23 with periosteal augmented grafts (PA-ACLR). The same surgical techniques, fixation methods, and postoperative protocol were used in both groups. Signal-to-noise quotient (SNQ), graft healing at the bone-graft interface, graft signal according to the Howell scale, and femoral tunnel widening were evaluated using MRI after 1 year of follow-up. International knee documentation score (IKDC), Lysholm, Tegner activity scale, and visual analog scale for pain were used for functional evaluation at a minimum of 2 years postoperative.
RESULTS: The mean SNQ of the proximal part of the graft was 9.6 ± 9.2 and 2.9 ± 3.3 for the ST-ACLR and PA-ACLR groups, respectively (P = 0.005). The mean femoral tunnel widening was 30.3% ± 18.3 and 2.3% ± 9.9 for the ST-ACLR, PA-ACLR groups, respectively (P < 0.001). Complete graft tunnel healing was observed in 65% and 28% of cases in the PA-ACLR and ST-ACLR groups, respectively. Both groups showed marked improvements in functional scores, with no statistically significant differences.
CONCLUSIONS: Periosteal wrapping of hamstring tendon autografts is associated with better graft healing and maturation and lower incidence of femoral tunnel widening based on MRI analysis 1 year after ACL reconstruction. However, patient-reported outcomes and measured laxity were similar between the two groups at 2 years follow up.
BACKGROUND: Trail registration number: PACTR202308594339018, date of registration: 1/5/2023, retrospectively registered at the Pan African Clinical Trial Registry (pactr.samrc.ac.za) database.
摘要：
背景：骨膜是腿筋收获部位的容易获得的组织，可用于增强移植物愈合并防止隧道加宽，而无需额外的成本或发病率。这项研究旨在比较使用磁共振成像（MRI）和功能临床结果评分的移植物愈合情况，这些患者接受了前交叉韧带（ACL）重建的患者，有或没有骨膜增强。
方法：前瞻性纳入48例接受ACL重建（ACLR）的患者：25例接受标准ACLR（ST-ACLR），23例接受骨膜增强移植物（PA-ACLR）。同样的手术技术，固定方法,两组均采用术后方案。信噪比(SNQ)，骨-移植物界面处的移植物愈合，根据豪厄尔尺度的移植信号，随访1年后使用MRI评估股骨隧道加宽。国际膝盖文件评分（IKDC），Lysholm,Tegner活动量表，术后至少2年使用疼痛视觉模拟量表进行功能评估.
结果：对于ST-ACLR和PA-ACLR组，移植物近端部分的平均SNQ分别为9.6±9.2和2.9±3.3，分别(P=0.005)。ST-ACLR的股骨隧道平均加宽率为30.3%±18.3和2.3%±9.9,PA-ACLR组,分别(P<0.001)。在PA-ACLR和ST-ACLR组中，有65%和28%的病例观察到移植物隧道完全愈合。分别。两组的功能评分均有明显改善，差异无统计学意义。
结论：ACL重建后1年MRI分析显示，自体绳肌腱移植物的骨膜包裹与更好的移植物愈合和成熟以及股骨隧道加宽的发生率较低相关。然而,2年随访时,两组患者报告的结局和测量的松弛度相似.
背景：Trail注册号：PACTR202308594339018，注册日期：1/5/2023，在泛非临床试验注册中心（pactr。Samrc.AC.za)数据库。
方法：前瞻性纳入48例接受ACL重建（ACLR）的患者：25例接受标准ACLR（ST-ACLR），23例接受骨膜增强移植物（PA-ACLR）。同样的手术技术，固定方法,两组均采用术后方案。信噪比(SNQ)，骨-移植物界面处的移植物愈合，根据豪厄尔尺度的移植信号，随访1年后使用MRI评估股骨隧道加宽。国际膝盖文件评分（IKDC），Lysholm,Tegner活动量表，术后至少2年使用疼痛视觉模拟量表进行功能评估.
结果：对于ST-ACLR和PA-ACLR组，移植物近端部分的平均SNQ分别为9.6±9.2和2.9±3.3，分别(P=0.005)。ST-ACLR的股骨隧道平均加宽率为30.3%±18.3和2.3%±9.9,PA-ACLR组,分别(P<0.001)。在PA-ACLR和ST-ACLR组中，有65%和28%的病例观察到移植物隧道完全愈合。分别。两组的功能评分均有明显改善，差异无统计学意义。
结论：ACL重建后1年MRI分析显示，自体绳肌腱移植物的骨膜包裹与更好的移植物愈合和成熟以及股骨隧道加宽的发生率较低相关。然而,2年随访时,两组患者报告的结局和测量的松弛度相似.
背景：Trail注册号：PACTR202308594339018，注册日期：1/5/2023，在泛非临床试验注册中心（pactr。Samrc.AC.za)数据库。
