Objective To compare the difference in stability of the knee joint after single-tunnel double-bundle and single-bundle anterior cruciate ligament (ACL) reconstruction.Methods Six formalin-soaked specimens of the human...Objective To compare the difference in stability of the knee joint after single-tunnel double-bundle and single-bundle anterior cruciate ligament (ACL) reconstruction.Methods Six formalin-soaked specimens of the human knee with retained展开更多
Background:The achievement of an optimal return to sport(RTS)has remained a key goal after sports-related injuries,with the ongoing debate on the effectiveness of different surgical approaches for anterior cruciate li...Background:The achievement of an optimal return to sport(RTS)has remained a key goal after sports-related injuries,with the ongoing debate on the effectiveness of different surgical approaches for anterior cruciate ligament(ACL)rupture.This study aims to assess clinical outcomes and RTS across various surgical methods,such as anatomical single-bundle reconstruction(ASBR),central-axial single-bundle reconstruction(CASBR),and double-bundle reconstruction(DBR).Methods:A randomized clinical trial was conducted,comprising 191 patients who underwent ACL rupture.These patients were divided into three groups based on the ACL reconstruction techniques they received(ASBR,CASBR,DBR).Over the 2-year follow-up period,the study assessed RTS through four single-hop tests,isokinetic extension tests,and limb asymmetry indices.Postoperative graft status was determined using the signal-to-noise quotient(SNQ),while knee function was evaluated using the International Knee Documentation Committee 2000(IKDC-2000)score,Lysholm score,Tegner score,and degree of knee laxity.A binary logistic regression model was developed to forecast the factors influencing ideal RTS.Results:DBR(67.63%)and CASBR(58.00%)exhibited higher RTS passing rates compared to ASBR(30.39%;χ^(2)=19.57,P<0.05).Quadriceps strength symmetry in the lower limbs was identified as the key determinant of RTS(χ^(2)=17.08,P<0.05).The RTS rate was influenced by SNQs of the graft’s tibial site(odds ratio:0.544)and quadriceps strength of the reconstructed knee joint at 60°/s(odds ratio:6.346).Notably,the DBR group showed enhanced knee stability,evidenced by superior results in the Lachman test(χ^(2)=13.49,P<0.01),objective IKDC-2000(χ^(2)=27.02,P=0.002),and anterior instability test(χ^(2)=9.46,P<0.01).Furthermore,DBR demonstrated superior clinical outcomes based on the Lysholm score(DBR:89.57±7.72,CASBR:83.00±12.71,ASBR:83.21±11.95;F=10.452,P<0.01)and IKDC-2000 score(DBR:90.95±7.00,CASBR:84.64±12.68,ASBR:83.63±11.41;F=11.78,P<0.01).Conclusion:For patients with ACL rupture,more ideal RTS rate and clinical outcomes were shown in the DBR group than in the ASBR and CASBR groups.Autograft status and quadriceps strength are postively related to RTS.展开更多
Objective： To evaluate the technique and outcome of arthroscopic sipy, le-bundie reconstruction of posterior crudate ligament （PCL） with quadrupled hamstring tendon. Methods： From April 2001 to October 2004, 49 k...Objective： To evaluate the technique and outcome of arthroscopic sipy, le-bundie reconstruction of posterior crudate ligament （PCL） with quadrupled hamstring tendon. Methods： From April 2001 to October 2004, 49 knees with PCL tears in 49 patients were verified with arthroscope in this department. Of them, 13 were combined with anterior cruciate ligament tears, 14 with disruptions of the posterolateral comer, 6 with ruptures of the posteromedial corner and medial collateral ligament, 9 with lateral meniscus tears, 5 with medial meniscus tears and 2 with popliteal vascular tears. All the damaged PCLs were reconstructed with single-bundie of autogenous quadrupled hamstring tendons under arthroscope. Biodegradable interference screws or blunt titanium interference screws were used for direct anatomic fixation of the reconstructed ligament. Results： After operation, no severe complications occurred at early stage in the 49 patients. All of them were followed up for 10-52 months with an average of 22. 0 months ＋ 10. 7 months. Lysholm score was remarkably improved from 30-60 （ mean： 47.96 ＋ 8. 16） preoperatively to 70-95 （ mean： 89. 08 ＋ 6. 10 ） at the last postoperative follow-up （ P 〈 0.01 ）. Furthermore, there was a significant improvement in International Knee Documentation Committee （IKDC） score from abnormal （ Grade C） in 10 knees and severely abnormal （Grade D ） in 39 preoperatively to normal （ Grade A ） in 20, nearly normal （ Grade B） in 24 and abnormal in 5 at the last follow-up. Of the 49 patients, 40 returned to the same activity level as before and 9 were under the level. Conclusions： Single-bundle reconstruction of PCL with quadrupled hamstring tendons has the advantage of minimal trauma in surgery and satisfactory outcome.展开更多
文摘Objective To compare the difference in stability of the knee joint after single-tunnel double-bundle and single-bundle anterior cruciate ligament (ACL) reconstruction.Methods Six formalin-soaked specimens of the human knee with retained
基金funded by Peking University Scientific Research Fund(No.BYSYDL2021001)Beijing Natural Science Fund(No.J210011)NSFC(Nos.82302656,82002298,and 51920105006).
文摘Background:The achievement of an optimal return to sport(RTS)has remained a key goal after sports-related injuries,with the ongoing debate on the effectiveness of different surgical approaches for anterior cruciate ligament(ACL)rupture.This study aims to assess clinical outcomes and RTS across various surgical methods,such as anatomical single-bundle reconstruction(ASBR),central-axial single-bundle reconstruction(CASBR),and double-bundle reconstruction(DBR).Methods:A randomized clinical trial was conducted,comprising 191 patients who underwent ACL rupture.These patients were divided into three groups based on the ACL reconstruction techniques they received(ASBR,CASBR,DBR).Over the 2-year follow-up period,the study assessed RTS through four single-hop tests,isokinetic extension tests,and limb asymmetry indices.Postoperative graft status was determined using the signal-to-noise quotient(SNQ),while knee function was evaluated using the International Knee Documentation Committee 2000(IKDC-2000)score,Lysholm score,Tegner score,and degree of knee laxity.A binary logistic regression model was developed to forecast the factors influencing ideal RTS.Results:DBR(67.63%)and CASBR(58.00%)exhibited higher RTS passing rates compared to ASBR(30.39%;χ^(2)=19.57,P<0.05).Quadriceps strength symmetry in the lower limbs was identified as the key determinant of RTS(χ^(2)=17.08,P<0.05).The RTS rate was influenced by SNQs of the graft’s tibial site(odds ratio:0.544)and quadriceps strength of the reconstructed knee joint at 60°/s(odds ratio:6.346).Notably,the DBR group showed enhanced knee stability,evidenced by superior results in the Lachman test(χ^(2)=13.49,P<0.01),objective IKDC-2000(χ^(2)=27.02,P=0.002),and anterior instability test(χ^(2)=9.46,P<0.01).Furthermore,DBR demonstrated superior clinical outcomes based on the Lysholm score(DBR:89.57±7.72,CASBR:83.00±12.71,ASBR:83.21±11.95;F=10.452,P<0.01)and IKDC-2000 score(DBR:90.95±7.00,CASBR:84.64±12.68,ASBR:83.63±11.41;F=11.78,P<0.01).Conclusion:For patients with ACL rupture,more ideal RTS rate and clinical outcomes were shown in the DBR group than in the ASBR and CASBR groups.Autograft status and quadriceps strength are postively related to RTS.
文摘Objective： To evaluate the technique and outcome of arthroscopic sipy, le-bundie reconstruction of posterior crudate ligament （PCL） with quadrupled hamstring tendon. Methods： From April 2001 to October 2004, 49 knees with PCL tears in 49 patients were verified with arthroscope in this department. Of them, 13 were combined with anterior cruciate ligament tears, 14 with disruptions of the posterolateral comer, 6 with ruptures of the posteromedial corner and medial collateral ligament, 9 with lateral meniscus tears, 5 with medial meniscus tears and 2 with popliteal vascular tears. All the damaged PCLs were reconstructed with single-bundie of autogenous quadrupled hamstring tendons under arthroscope. Biodegradable interference screws or blunt titanium interference screws were used for direct anatomic fixation of the reconstructed ligament. Results： After operation, no severe complications occurred at early stage in the 49 patients. All of them were followed up for 10-52 months with an average of 22. 0 months ＋ 10. 7 months. Lysholm score was remarkably improved from 30-60 （ mean： 47.96 ＋ 8. 16） preoperatively to 70-95 （ mean： 89. 08 ＋ 6. 10 ） at the last postoperative follow-up （ P 〈 0.01 ）. Furthermore, there was a significant improvement in International Knee Documentation Committee （IKDC） score from abnormal （ Grade C） in 10 knees and severely abnormal （Grade D ） in 39 preoperatively to normal （ Grade A ） in 20, nearly normal （ Grade B） in 24 and abnormal in 5 at the last follow-up. Of the 49 patients, 40 returned to the same activity level as before and 9 were under the level. Conclusions： Single-bundle reconstruction of PCL with quadrupled hamstring tendons has the advantage of minimal trauma in surgery and satisfactory outcome.
