Early clinical effect of new autologous semitendinosus ribbon-like graft in reconstruction of anterior cruciate ligament tear
10.3760/cma.j.cn501098-20211112-00583
- VernacularTitle:新型自体半腱肌带状移植物重建术治疗前交叉韧带断裂的早期临床疗效
- Author:
Ming LI
1
;
Yuqiang LIU
;
Shiji GAO
;
Qi GUO
;
Ning LIU
Author Information
1. 郑州市骨科医院运动医学科、河南省关节镜诊疗中心，郑州 450052
- Keywords:
Knee injuries;
Anterior cruciate ligament;
Arthroscopes
- From:
Chinese Journal of Trauma
2022;38(4):332-339
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the early curative effect of the new autologous semitendinosus ribbon-like graft in reconstruction of anterior cruciate ligament (ACL) tear.Methods:A retrospective cohort study was conducted to analyze the clinical data of 65 patients with knee ACL tear admitted to Zhengzhou Orthopedics Hospital from June 2019 to January 2021, including 52 males and 13 females, aged 16-50 years [(30.5±8.4)years]. According to the reconstruction method and graft selection, the patients were divided into ribbon-like reconstruction group ( n=31) and circular bundle reconstruction group ( n=34). All patients underwent anatomical ACL reconstruction using the new autologous semitendinosus ribbon-like graft in ribbon-like reconstruction group and the traditional circular bundle graft in circular bundle reconstruction group. The operation time, morphological difference in ACL graft immediately after surgery with original ACL, Lysholm score before and at 3 months after surgery, Lachman test and axial shift test immediately and at 3 months after surgery, and intraoperative and postoperative complications were compared between the two groups. Results:All patients were followed up for 3-15 months [(6.0±3.1)months]. The operation time was (61.6±6.7)minutes in ribbon-like reconstruction group and was (48.0±6.3)minutes in circular bundle reconstruction group ( P<0.01). Under arthroscopic observation, the original ACL was ribbon-shaped in the joint, the graft in ribbon-like reconstruction group was also ribbon-like structure, the graft in circular bundle reconstruction group was bundle structure. Therefore, the grafts in ribbon-like reconstruction group better simulated the ribbon-like structure of the original ACL than those in circular bundle reconstruction group. The ribbon-like graft mimiced the natural twisting of the ACL when the knee was bent. Lysholm score was (82.8±5.2)points in ribbon-like reconstruction group at 3 months after surgery, significantly higher than (47.5±8.7)points before surgery ( P<0.01). Lysholm score was (79.9±7.5)points in circular bundle reconstruction group at 3 months after surgery, significantly higher than (44.2±9.4)points before surgery ( P<0.01). There were no significant differences in Lysholm score between the two groups before and at 3 months after surgery (all P>0.05). Lachman and axial shift tests were negative in both groups immediately and at 3 months after surgery. The ribbon-like reconstruction group showed breakage or wear of Kirschner wires in 4 patients and hollow drill deformation in 1 intraoperatively. The circular bundle reconstruction group showed wear of Kirschner wires in 2 patients intraoperativley. There was no significant difference in intraoperative complications between the two groups ( P>0.05). One patient experienced tibial incision infection in ribbon-like reconstruction group at 3 months after surgery. All wounds were healed at stage I with no incision infection in circular bundle reconstruction group. No patients had ligament failure or function limitation. There was no significant difference in postoperative complications between the two groups ( P>0.05). Conclusions:The clinical effect of new autogenous semitendinosus ribbon-like graft in ACL reconstruction is comparable to that of traditional circular bundle graft. However, arthroscopic observation reveals that the parenchymal part of the ribbon-like graft is ribbon-shaped, which better simulates the physiological morphology of the original ACL. The natural distortion of the simulated ACL during knee bend may better simulate the physiological function of the original ACL.
