Comparison of Outcomes of Anterior Cruciate Ligament Reconstructions Using Patellar Tendon or Hamstring Tendon Autografts with Femoral Cross-pin Fixation

Yıl 2020, Cilt: 25 Sayı: 3, 192 - 199, 29.10.2020

Ömer Kays Unal Ülkü Sur Mirza Zafer Dağtaş Burak Demirağ

https://doi.org/10.21673/anadoluklin.735533

Öz

Aim: In this study, we aimed to compare outcomes of anterior cruciate ligament (ACL) reconstructions using bone–patellar tendon–bone graft (BPTG) or hamstring tendon graft (HTG) with cross-pin fixation at the femoral side.

Materials and Methods: The retrospective observational study included records of 100 patients who underwent ACL reconstruction with femoral cross-pin fixation between May 2008 and August 2012. The patients were divided into two groups according to the graft type used: the BPTG group and the HTG group. The preoperative and postoperative 6th-month Tegner Lysholm Knee Scoring Scale (TLKS) scores, International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC-SKF) scores, and Lachman test results were compared. The effects of meniscus lesion presence on the outcomes were also investigated.

Results: Of the 100 patients, 93 were male and 7 female. The HTG and BPTG groups consisted of 62 and 38 patients, respectively. The mean age was 24.1±4.9 (18–38) years for the HTG group and 32.1±6.8 (21–54) years for the BPTG group. The mean pre- and postoperative TLKS scores were respectively 50.5 and 94.3 in the BPTG group, and 49.9 and 95.2 in the HTG group. The mean pre- and postoperative IKDC-SKF scores were 51.3 and 95.6 in the BPTG group, and 51.8 and 95.6 in the HTG group. The postoperative score improvement was statistically significant in all patients (p<0.05), but there was no significant difference between the two groups. The postoperative improvement in knee stability was statistically significant in all patients (p<0.05). The postoperative score improvement was less in patients with meniscal injury (p<0.05).

Discussion and Conclusion: We found no significant difference between the two groups in terms of functional knee scores. However, the presence of meniscus lesions negatively affects the postoperative outcomes.

Anahtar Kelimeler

Anterior Cruciate Ligament Reconstruction, Orthopedic Fixation Devices, bone–patellar tendon–bone autograft, hamstring autograft

Femoral Cross-pin Fiksasyonu ile Patellar Tendon veya Hamstring Tendon Otogrefti Kullanılan Ön Çapraz Bağ Rekonstrüksiyonlarının Sonuçlarının Karşılaştırılması

Öz

Amaç: Bu çalışmada femoral tarafta cross-pin fiksasyonu ile kemik–patellar tendon–kemik grefti (KPTG) veya hamstring tendon grefti (HTG) kullanılan ön çapraz bağ (ÖÇB) rekonstrüksiyonlarının sonuçlarını karşılaştırmak amaçlanmıştır.

Gereç ve Yöntemler: Retrospektif gözlemsel çalışmamız Mayıs 2008—Ağustos 2012 döneminde femoral cross-pin fiksasyonlu ÖÇB rekonstrüksiyonu uygulanmış olan 100 hastanın kayıtlarını kapsadı. Hastalar, kullanılan greft türüne göre iki gruba ayrıldı: KPTG grubu ve HTG grubu. Preoperatif ve postoperatif 6. ay Tegner Lysholm Diz Skorlama Skalası (TLDS) skorları, Uluslararası Diz Dokümantasyon Komitesi Subjektif Diz Değerlendirme Formu (UDDK-SDF) skorları ve Lachman test sonuçları karşılaştırıldı. Ayrıca menisküs lezyonu varlığının sonuçlar üzerindeki etkisi incelendi.

Bulgular: Yüz hastanın 93’ü erkek, 7’si kadındı. HTG ve KPTG grupları sırasıyla 62 ve 38 hastadan oluştu. Ortalama yaş HTG grubu için 24,1±4,9 (18–38) yıl, KPTG grubu için 32,1±6,8 (21–54) yıl idi. Sırasıyla operasyon öncesi ve sonrası ortalama TLDS skorları KPTG grubu için 50,5 ve 94,3, HTG grubu için 49,9 ve 95,2 idi. Operasyon öncesi ve sonrası ortalama UDDK-SDF skorları KPTG grubu için 51,3 ve 95,6, HTG grubu için 51,8 ve 95,6 idi. Postoperatif skorlardaki yükseliş tüm hastalarda istatistiksel olarak anlamlıydı (p<0,05); fakat iki grup arasında anlamlı fark yoktu. Diz stabilitesindeki postoperatif artış tüm hastalarda istatistiksel olarak anlamlıydı (p<0,05). Menisküs yaralanması olan hastalarda postoperatif skorlardaki yükseliş daha azdı (p<0,05).

Tartışma ve Sonuç: İki grup arasında fonksiyonel diz skorları açısından anlamlı bir fark tespit edilmemiştir. Fakat menisküs lezyonu varlığı postoperatif sonuçları negatif etkilemektedir.

Anahtar Kelimeler

hamstring otogrefti, kemik–patellar tendon–kemik otogrefti, ortopedik fiksasyon cihazları, ön çapraz bağ rekonstrüksiyonu

Kaynakça

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