Similar outcomes between gracilis-reinforced ITB and HT with modified Lemaire technique in combined ACL reconstruction with lateral tenodesis: A propensity score-matched analysis.
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引用次数: 0
Abstract
Purpose: While both iliotibial band graft augmented by gracilis tendon (ITB + G) and hamstring autograft with modified Lemaire lateral extra-articular tenodesis (STG + LET) are established techniques for addressing rotatory instability in anterior cruciate ligament reconstruction, no direct comparison exists between these approaches. The purpose of this study was to provide the first direct comparison between these two surgical techniques regarding graft survival, functional outcomes and return to sport.
Methods: This single-centre, single-surgeon retrospective study analyzed 56 patients (28 per group) after 1:1 propensity score matching based on age, gender and Tegner activity scale. Primary end point was failure (graft retear or secondary meniscal lesion). Secondary outcomes included the International Knee Documentation Committee (IKDC), anterior cruciate ligament-return to sport after surgery (ACL-RSI) scores, and return to sport rate. Kaplan-Meier survival analysis and between-group comparisons were performed using appropriate statistical tests.
Results: At mean follow-up of 53.3 ± 6.4 months, failure-free survival rates at 24 months were 85.7% (95% confidence interval [CI]: 66.3-94.4) for STG + LET and 89.3% (95% CI: 70.4-96.4) for ITB + G (p = 0.664). Graft retear rate was 7.1% (STG + LET: 3.6%, ITB + G: 10.7%). Secondary meniscal injuries occurred equally (14.3%) in both groups. Return-to-sport rate was 89.3% at mean of 9.6 ± 3.9 months. Mean IKDC scores were 87.5 ± 11.4 for STG + LET and 83.6 ± 16.3 for ITB + G, with 73.7% achieving Patient Acceptable Symptom State criteria. ACL-RSI scores were similar between groups (STG + LET: 74.2 ± 24.3 and ITB + G: 73.5 ± 26.8).
Conclusion: No significant differences were found between ITB + G and STG + LET techniques regarding failure rates, return to sport and functional outcomes. Both techniques achieved satisfactory results in this cohort, with similar complication profiles. This comparison provides valuable clinical guidance, supporting surgical decision-making based on surgeon experience.
Level of evidence: Level III, retrospective cohort study.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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