Jia Li1, Fanlong Kong1, Xianda Gao1, Yong Shen1, Shijun Gao2. 1. Department of Orthopaedic Surgery and Key Laboratory of Orthopedic Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China. 2. Department of Orthopaedic Surgery and Key Laboratory of Orthopedic Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China. Electronic address: docsuke@163.com.
Abstract
PURPOSE: To evaluate posterior stability and proprioception after arthroscopic posterior cruciate ligament reconstruction with autograft, hybrid graft, and γ-irradiated allograft. METHODS: This prospective, randomized controlled trial (with 5 years' follow-up) included 90 patients who underwentposterior cruciate ligament reconstruction with autograft (gracilis and semitendinosus tendons), hybrid graft (γ-irradiated tibialis anterior tendon allograft and semitendinosus tendon autograft), or γ-irradiated allograft (tibialis anterior tendons). All the γ-irradiated allografts (tibialis anterior tendons) received an irradiation dose of 2.5 Mrad before distribution. Patients in this study had undergone a preoperative magnetic resonance imaging scan and physical examination. Patients were excluded from the study if they had a concomitant injury to other knee ligaments, previous surgery on the injured knee, or articular cartilage lesions greater than Outerbridge grade II. Clinical and proprioceptive evaluation results were collected preoperatively and at 3, 6, 12, 24, 36, and 60 months after surgery. RESULTS: The autograft, allograft, and hybrid graft groups were followed up for 5.5 ± 0.2 months (range, 5 to 6 years), 5.7 ± 0.3 months (range, 5 to 6 years), and 5.6 ± 0.5 months (range, 5 to 6 years), respectively. No statistically significant differences were found among the 3 groups regarding preoperative demographic factors (P > .05). The differences in physical examination findings and subjective evaluations among the 3 groups were not significant (P > .05). However, a significant difference was detected in instrumented anteroposterior measurements, with more laxity shown in the γ-irradiated allograft group than in the other 2 groups (P = .006). CONCLUSIONS: The differences in proprioceptive and functional outcomes among the 3 groups were not significant. In contrast, a significant difference was detected in instrumented anteroposterior measurements, which showed more laxity in the γ-irradiated allograft group than in the other 2 groups. However, this may not be clinically significant. LEVEL OF EVIDENCE: Level II, prospective comparative study.
RCT Entities:
PURPOSE: To evaluate posterior stability and proprioception after arthroscopic posterior cruciate ligament reconstruction with autograft, hybrid graft, and γ-irradiated allograft. METHODS: This prospective, randomized controlled trial (with 5 years' follow-up) included 90 patients who underwent posterior cruciate ligament reconstruction with autograft (gracilis and semitendinosus tendons), hybrid graft (γ-irradiated tibialis anterior tendon allograft and semitendinosus tendon autograft), or γ-irradiated allograft (tibialis anterior tendons). All the γ-irradiated allografts (tibialis anterior tendons) received an irradiation dose of 2.5 Mrad before distribution. Patients in this study had undergone a preoperative magnetic resonance imaging scan and physical examination. Patients were excluded from the study if they had a concomitant injury to other knee ligaments, previous surgery on the injured knee, or articular cartilage lesions greater than Outerbridge grade II. Clinical and proprioceptive evaluation results were collected preoperatively and at 3, 6, 12, 24, 36, and 60 months after surgery. RESULTS: The autograft, allograft, and hybrid graft groups were followed up for 5.5 ± 0.2 months (range, 5 to 6 years), 5.7 ± 0.3 months (range, 5 to 6 years), and 5.6 ± 0.5 months (range, 5 to 6 years), respectively. No statistically significant differences were found among the 3 groups regarding preoperative demographic factors (P > .05). The differences in physical examination findings and subjective evaluations among the 3 groups were not significant (P > .05). However, a significant difference was detected in instrumented anteroposterior measurements, with more laxity shown in the γ-irradiated allograft group than in the other 2 groups (P = .006). CONCLUSIONS: The differences in proprioceptive and functional outcomes among the 3 groups were not significant. In contrast, a significant difference was detected in instrumented anteroposterior measurements, which showed more laxity in the γ-irradiated allograft group than in the other 2 groups. However, this may not be clinically significant. LEVEL OF EVIDENCE: Level II, prospective comparative study.
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