Is contralateral autogenous patellar tendon graft a better choice than ipsilateral for anterior cruciate ligament reconstruction in young sportsmen? A randomized controlled trial.

Autor: de Souza Borges JH; Institute of Research and Teaching, Orthopedic Hospital and Specialized Medicine (IPE - H O M E), Brasília, Distrito Federal, Brazil; Department of Orthopedics, Traumatology and Sports Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. Electronic address: drjhumberto@gmail.com., Oliveira M; Institute of Research and Teaching, Orthopedic Hospital and Specialized Medicine (IPE - H O M E), Brasília, Distrito Federal, Brazil; University Center of Brasília (UniCEUB), Brasília, Distrito Federal, Brazil., Junior PL; Institute of Research and Teaching, Orthopedic Hospital and Specialized Medicine (IPE - H O M E), Brasília, Distrito Federal, Brazil., de Souza Machado R; Institute of Research and Teaching, Orthopedic Hospital and Specialized Medicine (IPE - H O M E), Brasília, Distrito Federal, Brazil., Lima R; Institute of Research and Teaching, Orthopedic Hospital and Specialized Medicine (IPE - H O M E), Brasília, Distrito Federal, Brazil., Ramos LA; Department of Orthopedics, Traumatology and Sports Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil., Cohen M; Department of Orthopedics, Traumatology and Sports Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2022 Jun; Vol. 36, pp. 33-43. Date of Electronic Publication: 2022 Apr 22.
DOI: 10.1016/j.knee.2022.03.015
Abstrakt: Aim: The aim of this study was to compare the peak extensor torque (primary outcome), sensory-motor capacity and Lysholm questionnaire score up to the fourth postoperative month post-primary anterior cruciate ligament reconstruction (ACLR) with bone-patellar-tendon-bone (BPTB) graft using either ipsilateral or contralateral technique in young sportsmen.
Methods: We performed a randomized controlled trial from 2018 to 2019. The same preoperative protocol, surgical technique and postoperative protocol were used in both groups. Eighty-eight young adult male patients were randomized, and 44 of each group completed the trial.
Results: After the follow up analysis, the contralateral receptor and donor limb demonstrated a statistically significant increase in peak extension torque compared with the ipsilateral operated limb (effect size (ES) = 0.99, power = 0.99, P < 0.0001; ES = 0.46, power = 0.56, P < 0.04). The symmetry between limbs was compared between groups. In the contralateral group, there was a significant decrease in the recipient limb (after surgery), compared with the donor limb (before surgery) (ES = 0.87, power = 0.99, P < 0.0001). In the ipsilateral group, the operated limb demonstrated a significant decrease in peak extension torque compared with the non-operated limb after surgery (ES = 1.88, power = 0.99, P < 0.0001). The comparison between groups in sensory-motor capacity and Lysholm score demonstrated a non-significant group effect postoperatively.
Conclusion: The use of contralateral BPTB is more effective in increasing peak extension torque when compared with ipsilateral technique in young sportsmen. Furthermore, patients achieved greater symmetry (side to side) in quadriceps muscle performance after the 4-month follow up with a contralateral graft.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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