| ObjectiveTo contrast the length, ultimate tensile strength, maximum deformation and inflexibility of autologous autologous peroneus long tendon, hamstring tendon and anterior cruciate ligament(ACL). To compare the surgery methods and clinical outcomes of arthroscopic ACL reconstruction with autologous fibula long tendon and hamstring tendon. To analyze the bone tunnel and ligament change of autologous fibula long tendon and hamstring tendon after ACL reconstruction by using magnetic resonance imaging(MRI).MethodsThis study contrasted the anatomical measurement and biomechanical test of the ultimate tensile strength, maximum deformation and inflexibility of autologous autologous peroneus long tendon, hamstring tendon and ACL with 20 cadaveric lower extremities and 16 amputated legs. The research measured the length, ultimate tensile strength, maximum deformation and inflexibility of the tendons with tensile testing machine. From January 2009 to October 2012, there were 60 cases of knee ACL reconstruction in Tangshan People Hospital, including 28 cases with single bundle autologous fibula long tendon reconstructions(Group A), 32 cases with autogenous hamstring tendon(Group B). Lachman test, pivot shift test, bilateral anterior laxity difference, leg circumference difference, Tegner score, Lysholm knee score and the IKDC score were used to assess the knee function both before and after surgery. Then we studied 38 inpatients ACL rupture with medial collateral ligament(MCL) injury of Grade Ⅲ,including 18 cases of ACL reconstruction with ipsilateral autologous autologous peroneus long tendon(Group A), and 22 cases with allogeneic semitendinosus tendon(Group B). MCL was fixed with line anchor nail and the assessment methods were as above. MRI was used to review the bone tunnel and ligament change of autologous fibula long tendon and hamstring tendon after ACL reconstruction from one week to 24 months, scanning the signal strength, morphology and continuity of the graft at the position of sagittalia, oblique sagittalia and coronal plane respectively.ResultsThe experiments showed that the ultimate tensile strength of fibula long tendon,hamstring tendon and ACL was 4268±285N, 4090±265N and 2020±264N; the maximum distortion was 9.87±2.56 mm, 12.27±2.78 mm, 15.90±3.52mm; the inflexibility was 986N/mm, 776N/mm, 697N/mm. There was no statistically significant difference(P<0.05). Both groups of patients with ACL reconstructions were followed up for 24 months or more. KT2000 score showed that both groups of knee stability have been significantly improved compared with the preoperative examination. However, there were no significantly difference in physical examination and Tegner score(6.32 ± 0.92 vs 5.97 ± 1.04).Lysholm score(94.90 ± 4.20 vs 93.97+8.62) between the two groups(P>0.05). In the third part of our study, Leg circumference decrease range was 1.01±0.21 cm and 1.03±0.12 cm in the two groups,respectively. There were no significant difference in the Lysholm knee score(94±6.67 vs 95±3.55), Tegner score(5±0.96 vs 6±0.03), IKDC score(90.48±2.36 vs90.17±4.32) between the two groups with autologous peroneus long tendon or hamstring tendon reconstruction(P> 0.05). MRI could accurately reflect the dynamic changes of the bone tunnel. There was no significant difference in the healed velocity in autologous peroneus long tendon and hamstring tendon reconstruction.ConclusionThe length, ultimate tensile strength, maximum deformation and inflexibility of autologous peroneus long tendon were superior to hamstring tendons. Reconstruction of ACL with single bundle autologous peroneus long tendon or hamstring tendon can both achieve excellent initial clinical results. When meeting soft tissue contusion,medial collateral ligament injury and anterior and posterior ligament rupture at the same time, reconstruction of ACL with autologous peroneus long tendon is a good choice. Peroneus longus tendon was a favorable new transplantation material and good choice for ACL reconstruction. |
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