Dr Jay Ebert, Dr Peter Edwards, Dr Adam Lawless, Mr Toby Leys, Mr Peter D’Alessandro
{"title":"一项随机对照试验,研究前十字韧带重建术后的功能恢复,采用单肌腱采集还是双肌腱采集","authors":"Dr Jay Ebert, Dr Peter Edwards, Dr Adam Lawless, Mr Toby Leys, Mr Peter D’Alessandro","doi":"10.31189/2165-7629-13-s2.318","DOIUrl":null,"url":null,"abstract":"\n \n Anterior cruciate ligament (ACL) tears are common. While surgical reconstruction (ACLR) is commonly advocated and a hamstring autograft is the popular choice, hamstring tendon harvest has been linked to reduced hamstring strength and ongoing donor site pain. While traditional surgical techniques required a harvest of both semitendinosus/gracilis tendons, modern harvesting and fixation methods permit a shorter, broader harvest of semitendinosus only. This study investigated donor site pain, strength and functional recovery in patients undergoing ACLR via a single (ST) versus dual (DT) tendon hamstring harvest.\n \n \n \n This prospective randomized controlled trial (RCT) allocated 138 patients to ACLR with one of the two hamstring tendon graft options (ST=71, DT=67) followed by a structured rehabilitation program. Patients were assessed pre-surgery and at 3, 6, and 12 months, with a range of patient-reported outcome measures (PROMs) including a validated donor-site morbidity score. Graft laxity, peak isokinetic knee extensor and flexor strength and a 6-hop performance battery were assessed. Limb Symmetry Indices (LSIs) were calculated.\n \n \n \n All PROMs significantly improved (p<0.0001) and were largely similar between groups (p>0.05), apart from significantly less graft morbidity reported in the ST group (p=0.001). No group differences were observed for knee laxity or LSIs for hop measures (p>0.05), nor the LSIs for peak knee flexor (p=0.113) or extensor (p=0.286) torque.\n \n \n \n While the ST ACLR group reported significantly less harvest site morbidity, no other subjective or functional differences were observed in patients undergoing ACLR with either a single or dual hamstring tendon autograft harvest.\n","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A RANDOMIZED CONTROLLED TRIAL INVESTIGATING FUNCTIONAL RECOVERY AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING A SINGLE VERSUS DOUBLE TENDON HARVEST\",\"authors\":\"Dr Jay Ebert, Dr Peter Edwards, Dr Adam Lawless, Mr Toby Leys, Mr Peter D’Alessandro\",\"doi\":\"10.31189/2165-7629-13-s2.318\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n Anterior cruciate ligament (ACL) tears are common. While surgical reconstruction (ACLR) is commonly advocated and a hamstring autograft is the popular choice, hamstring tendon harvest has been linked to reduced hamstring strength and ongoing donor site pain. While traditional surgical techniques required a harvest of both semitendinosus/gracilis tendons, modern harvesting and fixation methods permit a shorter, broader harvest of semitendinosus only. This study investigated donor site pain, strength and functional recovery in patients undergoing ACLR via a single (ST) versus dual (DT) tendon hamstring harvest.\\n \\n \\n \\n This prospective randomized controlled trial (RCT) allocated 138 patients to ACLR with one of the two hamstring tendon graft options (ST=71, DT=67) followed by a structured rehabilitation program. Patients were assessed pre-surgery and at 3, 6, and 12 months, with a range of patient-reported outcome measures (PROMs) including a validated donor-site morbidity score. Graft laxity, peak isokinetic knee extensor and flexor strength and a 6-hop performance battery were assessed. Limb Symmetry Indices (LSIs) were calculated.\\n \\n \\n \\n All PROMs significantly improved (p<0.0001) and were largely similar between groups (p>0.05), apart from significantly less graft morbidity reported in the ST group (p=0.001). No group differences were observed for knee laxity or LSIs for hop measures (p>0.05), nor the LSIs for peak knee flexor (p=0.113) or extensor (p=0.286) torque.\\n \\n \\n \\n While the ST ACLR group reported significantly less harvest site morbidity, no other subjective or functional differences were observed in patients undergoing ACLR with either a single or dual hamstring tendon autograft harvest.\\n\",\"PeriodicalId\":92070,\"journal\":{\"name\":\"Journal of clinical exercise physiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of clinical exercise physiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31189/2165-7629-13-s2.318\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of clinical exercise physiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31189/2165-7629-13-s2.318","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
A RANDOMIZED CONTROLLED TRIAL INVESTIGATING FUNCTIONAL RECOVERY AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING A SINGLE VERSUS DOUBLE TENDON HARVEST
Anterior cruciate ligament (ACL) tears are common. While surgical reconstruction (ACLR) is commonly advocated and a hamstring autograft is the popular choice, hamstring tendon harvest has been linked to reduced hamstring strength and ongoing donor site pain. While traditional surgical techniques required a harvest of both semitendinosus/gracilis tendons, modern harvesting and fixation methods permit a shorter, broader harvest of semitendinosus only. This study investigated donor site pain, strength and functional recovery in patients undergoing ACLR via a single (ST) versus dual (DT) tendon hamstring harvest.
This prospective randomized controlled trial (RCT) allocated 138 patients to ACLR with one of the two hamstring tendon graft options (ST=71, DT=67) followed by a structured rehabilitation program. Patients were assessed pre-surgery and at 3, 6, and 12 months, with a range of patient-reported outcome measures (PROMs) including a validated donor-site morbidity score. Graft laxity, peak isokinetic knee extensor and flexor strength and a 6-hop performance battery were assessed. Limb Symmetry Indices (LSIs) were calculated.
All PROMs significantly improved (p<0.0001) and were largely similar between groups (p>0.05), apart from significantly less graft morbidity reported in the ST group (p=0.001). No group differences were observed for knee laxity or LSIs for hop measures (p>0.05), nor the LSIs for peak knee flexor (p=0.113) or extensor (p=0.286) torque.
While the ST ACLR group reported significantly less harvest site morbidity, no other subjective or functional differences were observed in patients undergoing ACLR with either a single or dual hamstring tendon autograft harvest.