Manit Arora, Sachin Tapasvi, Tapish Shukla, Sahil Garg, Jay Shah
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引用次数: 0
Abstract
Purpose: Peroneus longus (PL) graft harvest has recently gained popularity for various ligament reconstruction surgeries. A recent systematic review shows it is a safe and reproducible technique with low morbidity of donor sites (1). The method for PL harvest routinely involves tenodesis of the PL stump to the peroneus brevis (PB). To the authors' best knowledge, no study exists in the literature that has compared the outcomes of tenodesis versus no tenodesis on post-operative ankle functional outcome scores. The purpose of the present study is to assess the importance of tenodesis on post-operative ankle scores.
Methods: A total of 200 consecutive patients from July 2022 to November 2022 were included in the study: 72 in the no tenodesis group and 128 in the tenodesis group. Institutional ethics approval was obtained from the institutional ethics review committee before the initiation of the study. Demographic variables (age, gender and level of play) were recorded. Pre-operative American Orthopaedic Foot and Ankle Society Score (AOFAS) and Functional Ankle Disability Index (FADI) scores were calculated for both groups and compared with post-operative scores at six weeks, three months, six months and one-year follow-up.
Results: For the entire study population (n = 200), we found that AOFAS and FADI scores showed no significant difference at any interval except for lower scores at six weeks of follow-up for both groups compared to baseline. We found that the no tenodesis group had slightly better AOFAS and FADI scores at the six-week follow-up, which were statistically significant (p < 0.05). However, the magnitude of variance (0.13 and 0.20, respectively) was too small to be clinically significant. Age, gender and level of play had no impact on ankle functional outcomes.
Conclusion: Tenodesis of the PL to the PB has been the standard norm in PL graft harvest for various ligament surgeries. The present high-powered prospective cohort study shows that tenodesis.does not improve ankle functional outcome scores compared to no tenodesis. Further work is needed to assess the impact of tenodesis or no tenodesis on ankle biomechanics (eversion, plantarflexion and gait).
目的：腓骨长肌（PL）移植收获近年来在各种韧带重建手术中得到了广泛的应用。最近的一项系统综述显示，这是一种安全、可重复的技术，供体部位的发病率低(1)。腓骨短肌采集的常规方法包括将腓骨短肌残端固定在腓骨短肌（PB）上。据作者所知，文献中没有研究比较过肌腱固定术和未肌腱固定术对术后踝关节功能评分的影响。本研究的目的是评估肌腱固定术对术后踝关节评分的重要性。方法：共纳入2022年7月至2022年11月连续200例患者，其中不固定组72例，固定组128例。在研究开始前获得了机构伦理审查委员会的机构伦理批准。记录人口统计变量（年龄、性别和游戏水平）。计算两组患者术前American Orthopaedic Foot and Ankle Society Score （AOFAS）和Functional Ankle Disability Index （FADI）评分，并在随访6周、3个月、6个月和1年后比较两组患者的术后评分。结果：对于整个研究人群（n = 200），我们发现AOFAS和FADI评分在任何间隔都没有显着差异，除了两组在随访6周时的评分较基线低。我们发现，在6周的随访中，无肌腱固定术组的AOFAS和FADI评分稍好，差异有统计学意义(p)。结论：在各种韧带手术中，肌腱固定术已成为韧带移植收获的标准规范。目前的高强度前瞻性队列研究表明，肌腱固定术。与不做肌腱固定术相比，不能改善踝关节功能评分。需要进一步的工作来评估肌腱固定或不肌腱固定对踝关节生物力学（外翻、跖屈和步态）的影响。证据等级：四级。
期刊介绍：
IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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