Semitendinosus vs quadriceps tendon autograft in anterior cruciate ligament reconstruction (SEQUAR): protocol for a prospective randomized controlled trial.

IF 2.4 3区 医学 Q2 ORTHOPEDICS
Daniel Castellanos Dolk, Vasileios Sarakatsianos, Tobias Wörner, Mikael Östin, Riccardo Cristiani, Joanna Kvist, Anders Stålman
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引用次数: 0

Abstract

Background: Anterior cruciate ligament (ACL) rupture is a devastating injury for most individuals, especially in athletes with the desire to go back to pivoting sports. In ACL reconstruction (ACL-R), multiple autograft options are available, each with distinct advantages and limitations. The quadriceps tendon (QT) autograft has gained increasing attention due to its favorable biomechanical properties and lower donor site morbidity, yet studies comparing only athletic populations remains limited. This study protocol describes a randomized controlled trial (RCT) aiming to compare QT autograft with bone-block (QT-B) with semitendinosus tendon (ST) autograft in athletes undergoing primary ACL-R.

Methods: This is a single center RCT. Two Hundred ACL-R patients aged 16-40 years with a Tegner Activity Scale (TAS) of ≥ 7 prior to the ACL injury will be randomized to receive either a ST graft or a QT-B graft at the time of ACL-R. All participants will receive standard postoperative care and rehabilitation, followed by comprehensive follow-up. The primary outcome was the side-to-side (STS) difference in anterior tibial translation (ATT) at 6 months. Secondary outcomes include patient-reported outcome measures (PROMs), isokinetic strength testing, imaging-based graft evaluation, surgical and clinical events, and 10-year radiographic evidence of joint degeneration. Detailed definitions and timepoints are provided in the full manuscript (Table 1).

Discussion: This protocol is the first RCT comparing the ST autograft to the QT-B autograft exclusively in athletes with TAS ≥ 7 undergoing ACL-R. In addition, this trial has the ambition of including 200 patients, thereby making it the largest trial to compare these two grafts to date. The successful completion of the trial has the potential to change current practice and contribute to the existing knowledge regarding graft choice in athletes undergoing ACL-R.

Trial registration: The trial is registered at ClinicalTrials.gov: NCT04295148. Registered date: 4 Mar 2020 (retrospectively registered).

前交叉韧带重建(SEQUAR)中的半腱肌与自体股四头肌肌腱移植:一项前瞻性随机对照试验的方案。
背景:前交叉韧带(ACL)断裂对大多数人来说是一种毁灭性的损伤,特别是对那些希望回到旋转运动的运动员来说。在ACL重建(ACL- r)中,有多种自体移植物可供选择,每种都有其独特的优点和局限性。自体四头肌肌腱(QT)由于其良好的生物力学特性和较低的供区发病率而受到越来越多的关注,但仅比较运动人群的研究仍然有限。本研究方案描述了一项随机对照试验(RCT),旨在比较自体QT间期骨块移植(QT- b)和自体半腱肌腱移植(ST)对原发ACL-R运动员的疗效。方法:采用单中心随机对照试验。200名年龄在16-40岁、ACL损伤前Tegner活动量表(TAS)≥7的ACL- r患者将被随机分组,在ACL- r时接受ST移植或QT-B移植。所有参与者将接受标准的术后护理和康复,然后进行全面的随访。主要结果是6个月时胫骨前平移(ATT)的侧对侧(STS)差异。次要结果包括患者报告的结果测量(PROMs)、等速强度测试、基于成像的移植物评估、手术和临床事件以及关节退变的10年影像学证据。全文提供了详细的定义和时间点(表1)。讨论:该方案是第一个比较ST自体移植物和QT-B自体移植物的RCT,专门针对TAS≥7的接受ACL-R的运动员。此外,该试验的目标是纳入200名患者,从而使其成为迄今为止比较这两种移植物的最大试验。该试验的成功完成有可能改变目前的做法,并有助于对ACL-R运动员移植选择的现有知识。试验注册:该试验在ClinicalTrials.gov上注册:NCT04295148。注册日期:2020年3月4日(追溯注册)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders 医学-风湿病学
CiteScore
3.80
自引率
8.70%
发文量
1017
审稿时长
3-6 weeks
期刊介绍: BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.
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