目的:比较患者报告的结果测量值(PROM)和随后的手术干预措施,这些患者使用股四头肌腱自体移植带髌骨骨块(bQT)或仅使用软组织(sQT)进行前交叉韧带重建(ACLR)。
方法:所有在2010年1月至03.2022年期间进行的ACLRs均前瞻性随访24个月并进行回顾性评估。所有主要ACLRs具有完整的24个月随访数据,以前没有任何手术或任何额外的韧带干预,与主要ACL风险因素相匹配,包括性别,年龄,Tegner活动水平(TAL),旋转运动,和伴随的伤害。PROMs(Lysholm评分,疼痛的视觉模拟量表(VAS),和TAL)以及随后的手术干预在术后6、12和24个月后进行记录。二元logistic回归用于评估移植物类型的影响,年龄,伤前TAL,性别,枢轴运动和伴随的干预措施需要进行后续手术。
结果:匹配后,246名患者被纳入最终分析。两组在术前患者人口统计学或术中细节方面均无差异。在最后的后续行动中,Lysholm平均评分无显著差异(sQT:90.8±10.6,bQT:91.8±10.6,p=.46),中位TAL(sQT:6[1-10],bQT:6[1-10],p=.53)和疼痛的VAS(sQT:0.7±1.1,bQT:0.7±1.2,p=.70)在两组之间报告。70.3%(sQT-A:70.7%,bQT:69.9%,p=.89)的患者恢复到或超过了受伤前的活动水平。在修订ACLR方面,bQT(3.3%)和sQT(4.1%)差异无统计学意义。同样,对侧ACLR无差异(bQT:7.3%sQT:11.4%).回归分析表明,没有研究的因素,包括使用髌骨块,影响了随后的手术,修订ACLR,或对侧ACLR。
结论:在股四头肌肌腱ACL重建术中收获额外的髌骨块似乎不会影响患者报告的术后结局,ACL修订或对侧ACL重建率。
方法:第3级-队列研究。
OBJECTIVE: To compare patient-reported outcomes measurements (PROMs) and subsequent surgical interventions in patients treated with anterior cruciate ligament reconstruction (ACLR) using either quadriceps tendon autograft with a patellar bone block (bQT) or soft tissue only (sQT).
METHODS: All ACLRs performed between 01.2010 and 03.2022 were prospectively followed for 24 months and retrospectively evaluated. All primary ACLRs with full 24 months of follow-up data, without any previous surgery or any additional ligamentous interventions, were matched for major ACL risk factors, including gender, age, Tegner activity level (TAL), pivoting sports, and concomitant injuries. PROMs (Lysholm score, Visual Analog Scale (VAS) for pain, and TAL) and subsequent surgical interventions were registered after 6, 12, and 24 months postoperative. Binary logistic regression was used to assess the influence of graft type, age, preinjury TAL, gender, pivoting sports and concomitant interventions on the need to undergo subsequent surgery.
RESULTS: After matching, 246 patients were included in the final analysis. Both groups did not differ regarding any preoperative patient demographics or intraoperative details. At final follow-up, no significant difference in mean Lysholm score (sQT: 90.8±10.6, bQT: 91.8±10.6, p= .46), median TAL (sQT: 6 [1-10], bQT: 6 [1-10], p= .53) and VAS for pain (sQT: 0.7±1.1, bQT: 0.7±1.2, p= .70) was reported between both groups. 70.3% (sQT-A: 70.7%, bQT: 69.9%, p= .89) of patients returned to or exceeded their preinjury activity level. In terms of revision ACLR, there was no statistically significant difference between bQT (3.3%) and sQT (4.1%). Similarly, no difference was observed in contralateral ACLR (bQT: 7.3% sQT: 11.4%). Regression analysis indicated that none of the studied factors, including the use of a patellar bone block, influenced subsequent surgery, revision ACLR, or contralateral ACLR.
CONCLUSIONS: Harvesting an additional patellar bone block in quadriceps tendon ACL reconstruction does not seem to impact postoperative patient-reported outcomes, ACL revision- or contralateral ACL reconstruction rates.
METHODS: Level 3 - Cohort Study.