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BACKGROUND: In recent years, it has been reported that peroneus longus tendon can be used as a new graft material for anterior cruciate ligament reconstruction and can achieve the same effect as hamstring tendon. Therefore, it is necessary to systematically evaluate the two graft materials for anterior cruciate ligament reconstruction. OBJECTIVE: To evaluate the clinical effect of reconstruction of anterior cruciate ligament with peroneus longus tendon and hamstring tendon by meta-analysis. METHODS: We retrieved controlled clinical trials which compared the long peroneal tendons and hamstring tendons in reconstructing anterior cruciate ligament respectively in Chinese database (WanFang, CNKI, VIP, Chinese biological medicine) and English database (Ovid, PubMed, Web of Science, Embase, the Cochrane library). The retrieval time was from database creation to March 2019. Literature screening and evaluation and data extraction were performed by two evaluators. Meta-analysis was evaluated using Revman5. 3 software. RESULTS AND CONCLUSION: (1) A total of 413 Chinese or English literatures were retrieved and 10 of them were included in the final analysis. Among 647 patients receiving anterior cruciate ligament reconstruction, 271 patients used peroneus longus tendon reconstruction and 376 patients used hamstring tendon reconstruction. (2) Meta-analysis results: Postoperative functional score: There was significant difference in Lysholm score at postoperative 12 months (MD=1. 23, 95%C/[0. 31, 2. 51], P=0. 000 9) and IKDC score at postoperative 6 months (MD=3. 19, 95%C/[0. 07, 6. 31], P=0. 02) between peroneus longus tendon reconstruction and hamstring tendon groups. The occurrence of postoperative complications in the peroneus longus tendon group was significantly lower than that in the hamstring tendon group (OR=0. 15, 95%C/[0. 03, 0. 69], P=0. 01). However, there were no significant differences in Tegner scores, degree of joint motion, degree of joint relaxation at postoperative 6 and 12 months between peroneus longus tendon reconstruction and hamstring tendon groups. No significant difference was found in Lysholm score at postoperative 6 months and in IKDC score at postoperative 12 months between these two groups. The results showed that the clinical effect of peroneus longus tendon in reconstruction of anterior cruciate ligament was comparable to that of hamstring tendon; in the peroneus longus tendon reconstruction group, the Lysholm score at postoperative 12 months and IKDC score at postoperative 6 months were significantly superior to those in the hamstring tendon group. The incidence of postoperative complications in the peroneus longus tendon reconstruction group was lower than that in the hamstring tendon group. The peroneus longus tendon can be clinically recommended to substitute hamstring tendon in the reconstruction of the anterior cruciate ligament. However, the quality of included literatures is limited; therefore higher quality of evidence is required to validate this conclusion.
ABSTRACT
BACKGROUND: Rupture of the anterior cruciate ligament (ACL) is one of the most common sports injuries of the knee joint. Today, we have a large number of approaches to arthroscopic reconstruction of the anterior cruciate ligament that lead to successful outcomes and allow the patients to return to a significant level of activity post-operatively. Nevertheless, the return to competitions rate stays relatively low. The functional state is thought to be dependent on rotational and anteroposterior stability of the knee. These data encourage search for methods of additional stabilization of the knee joint, one of them being extra-articular tenodesis, or reconstruction of anterolateral ligament of the knee. THE AIM OF THE STUDY: To evaluate medium-term results of combined simultaneous arthroscopic reconstruction of anterior cruciate ligament and anterolateral ligament of the knee joint in sportsmen and to access the probability of return to competitions. MATERIALS AND METHODS: The surgeries were performed in 2014-2015 in 50 patients who fulfilled the entry criteria: 20 patients (including 10 professional sportsmen) underwent arthroscopic ACL reconstruction together with reconstruction of anterolateral ligament-group 1 (main group), and 30 patients (including 10 professional sportsmen) underwent arthroscopic ACL reconstruction-group 2 (control group). RESULTS: Group 1: All patients of group 1 were able to return to the pre-operative sports level in two years after the surgery. The mean Tegner Lysholm score was 72.6 ± 6.45 (hereinafter, SE-standard error) before the surgery and 97.4 ± 1.18 after the surgery. The mean IKDC score was 63.1 ± 4.8% before the surgery and 96.3 ± 1.8% after the surgery. Group 2: 20 of 30 patients (66.7%) returned to the pre-operative level of activity and returned to competitions (if they were professional sportsmen) in a year after the surgery. Five of ten patients (50%) (professional sportsmen) returned to competitions. Fifteen of 20 patients (75%) (amateur sportsmen) also returned to competitions. The mean pre-operative Tegner Lysholm score was 69.6 ± 3.5, and the mean post-operative score was 92.1 ± 3.9. The mean pre-operative IKDC score was 73.4 ± 3.2%, and the mean post-operative score was 90.3 ± 3.7%. CONCLUSION: The results of the study show that more patients with higher functional demands and more professional sportsmen returned to sports. Despite the results of our and other foreign studies, a need remains for studies that will compare outcomes of ALL reconstruction with the same surgical technique in homogenous groups of patients.
Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Athletic Injuries/surgery , Knee Joint/surgery , Anterior Cruciate Ligament Reconstruction/methods , Athletes , Female , Humans , MaleABSTRACT
Objective To investigate the feasibility of fast track surgery (FTS) application in arthroscopic reconstruction of anterior cruciate ligament.Methods A total of 80 cases of anterior cruciate ligament(ACL) tear patients were randomized into two groups.While the experimental group (n =42) was treated with the conception of FTS, and the control group(n =38) was treated with the traditional methods.The postoperative pain, knee Lysholm score, quality of life score (SF-36), knee joint activity (EUROPEP), and postoperative infection were compared between the two groups.Result The VAS score of post-operation pain (VAS) 1 h(1.80±1.13) ,6 h(1.91±0.98), 12 h(1.73±0.95) ,24 h(1.68±0.65) ,48 h(1.69±0.90) ,the time stay in hospital (7 ± 1), total cast (205 600 ± 7 600) yuan, were significantly decreased compared to the traditional therapy group(VAS : (7.00± 1.56), (7.41±0.93), (6.82±1.12), (6.65±0.76), (6.34±0.88) ,P ＜0.05 or P＜0.01;(12± 1) d, P =0.021;(28 600±5 400) yuan, P =0.042).Recovery time of ROM of experimental group was significant lower than control group (P ＜ 0.05).But the comparison of patients, satisfaction of post-operation in two groups was inverse(P=0.007).The Lycholm scores of post-operation of FTS group were remarkably higher than the control group and the scores of prior treatment(85.1 ± 14.2) vs (73.6 ±12.3);P＜ 0.05).Conclusion The new methods of FTS can apparently accelerates recovery after ACL reconstruction,reduces complications, shorten time stay in hospital, cut down the total cost, and improve the experience and the satisfaction of patients.It was safety and feasible.
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[Objective]To investigate the effect of reconstituted bone xenografts(RBX) on tendon-to-bone healing by means of imaging,histological and biomechanical studies.[Method]Anterior cruciate ligament(ACL) reconstruction was performed bilaterally in 25 skeletally mature rabbits using long digital extensor tendon grafts.RBX were implanted into the treated knee of each rabbit,with the contralateral knees as controls.Every three rabbits were killed at 2,6 and 12 weeks postoperatively for routine histological studies.The samples were processed through Micro CT and subsequent HE and toludine blue staining.The remaining 16 rabbits were sacrificed at 6 and 12 weeks.Their femur-tendon graft-tibia complexes were harvested for subsequent mechanical testing.[Result]At 6 and 12 weeks after operation,the values of BMD in the RBX group were higher than those in the control group(P
