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Fremdmaterialfreie Rekonstruktion des vorderen Kreuzbandes mit autologer Quadrizepssehne

Anterior cruciate ligament reconstruction using quadriceps tendon autograft and press-fit fixation

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Zusammenfassung

Hintergrund

Evaluiert wurden funktionelle, klinische und radiologische Ergebnisse nach arthroskopischer Rekonstruktion des vorderen Kreuzbandes mit autologer Quadrizepssehne in fremdmaterialfreier Press-fit-Technik.

Methodik

Prospektiv wurden 112 Patienten mit primärer vorderer Kreuzbandruptur in die Studie eingeschlossen. Durchschnittlich 12,4 (12–14 Monate) postoperativ konnten 106 Patienten (95%) nachuntersucht werden.

Ergebnisse

Subjektiv zufrieden mit dem Operationsergebnis waren 87% der Patienten. Sehr gute und gute Ergebnisse im funktionellen Lysholm-Score erreichten 81%, im International-Knee-Documentation-Committee- (IKDC-)Score erzielten 86% normale oder fast normale Werte. Der Unterschied des Aktivitätsniveaus im Tegner-Score von 7 (Median) vor der Verletzung und 6 bei der Nachuntersuchung war nicht signifikant (p=0,11). Die Stabilitätstestung mittels KT-1000-Arthrometer zeigte in 83% der Fälle eine Differenz der anterioren Translation von weniger als 3 mm im Seitenvergleich. Radiologisch fanden sich weder eine Zunahme degenerativer Veränderungen noch eine Erweiterung der Bohrkanäle.

Schlussfolgerung

Diese Operationsmethode kann dem jungen, aktiven Patienten mit Insuffizienz des vorderen Kreuzbandes empfohlen werden. Sie sollte weiter evaluiert und mit anderen Verfahren kritisch verglichen werden.

Abstract

Background

Reconstruction of the anterior cruciate ligament (ACL) is a widely used procedure, but up to now no results have been published on an implant-free technique using a quadriceps tendon autograft and press-fit fixation.

Methods

A total of 112 patients with primary rupture of the anterior cruciate ligament were included in a prospective case control study and 106 patients could be evaluated postoperatively after a mean of 12.4 months (range 12–14 months).

Results

The patients showed good to excellent results according to the Lysholm score in 81% and the International Knee Documentation Committee (IKDC) score in 86% of cases. Furthermore the anterior-posterior translation was less than 3 mm in 83% of the patients by testing with the KT-1000 arthrometer. Neither tunnel widening nor an increase of radiological joint degeneration was recorded by radiological examination.

Conclusion

Reconstruction of the ACL with an autologous quadriceps tendon and an implant-free technique yielded good results compared to established operative methods in the short-term and should be consistently followed-up for long-term confirmation.

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Interessenkonflikt

Der korrespondierende Autor gibt an, dass diese Studie durch Drittmittel der Firma Richard Wolf GmbH (Knittlingen, Germany) finanziert wurde.

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Authors and Affiliations

  1. Sektion Sportorthopädie, Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland

    A. Barié, S. Kargus, H. Schmitt & N.A. Streich

  2. Orthopädische Gemeinschaftspraxis an der St.-Elisabeth-Klinik Heidelberg, Heidelberg, Deutschland

    J. Huber

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  1. A. Barié
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  2. S. Kargus
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  3. J. Huber
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  4. H. Schmitt
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  5. N.A. Streich
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Correspondence to A. Barié.

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Barié, A., Kargus, S., Huber, J. et al. Fremdmaterialfreie Rekonstruktion des vorderen Kreuzbandes mit autologer Quadrizepssehne. Unfallchirurg 113, 629–634 (2010). https://doi.org/10.1007/s00113-010-1854-0

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  • DOI: https://doi.org/10.1007/s00113-010-1854-0

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