临床外科杂志 ›› 2020, Vol. 28 ›› Issue (11): 1039-1042.doi: 10.3969/j.issn.1005-6483.2020.11.013

• 论著 • 上一篇    下一篇

关节镜下保残单束解剖重建前交叉韧带的近期疗效观察

  

  1. 湖北武汉,解放军中部战区总医院骨科
  • 出版日期:2020-11-20 发布日期:2020-11-20

Shortterm effectiveness of Arthroscopic anterior cruciate ligament anatomic single bundle reconstruction with remnant preservation

  • Online:2020-11-20 Published:2020-11-20

摘要: 目的:探讨关节镜下前交叉韧带(anterior cruciate ligament,ACL)保残单束解剖重建术的近期疗效及意义。方法:2012年1月~2016年7月采用关节镜下ACL解剖重建术治疗的ACL断裂病人,根据术中残端的处理方式的分为两组,其中保留胫骨、股骨侧韧带残端组(保残组)38例,清除韧带残端组(常规组)41例。在术后6个月、12个月随访时对病人的轴移试验、Lachman试验、KT1000、角度还原试验、IKDC分级和Lysholm评分进行记录并统计对比分析。结果:所有病人在术后6个月、12个月均获得良好随访。术后6个月随访,轴移试验阳性率保残组为13.2%,常规组为29.2%;Lachman试验阳性率保残组为10.5%,常规组为26.8%;角度还原试验保残组为(3.56±1.73)°,常规组为(4.84±1.85)°,两组比较差异均具有统计学意义(P<0.05)。KT1000测量值保残组为(1.8±0.9)mm,常规组为(2.2±1.3)mm,两组比较差异无统计学意义(P>0.05)。术后12个月随访,轴移试验阳性率保残组为7.9%,常规组为21.9%;Lachman试验阳性率保残组为7.9%,常规组为24.3%;KT1000测量值保残组为(1.2±0.8)mm,常规组为(1.7±1.0)mm;IKDC评分分级保残组A级占81.6%,常规组A级占68.3%;Lysholm评分保残组为(96.4±3.1)分,常规组为(92.1±4.3)分,两组比较差异均具有统计学意义(P<0.05)。角度还原试验保残组为(2.75±1.33)°,常规组为(3.28±1.51)°,两组比较差异无统计学意义(P>0.05)。结论:采用关节镜下ACL解剖重建术治疗ACL断裂可取得良好的近期临床疗效,保留残端组病人术后近期膝关节稳定性和本体感觉的恢复较常规组更好。

关键词: 关节镜检查, 前交叉韧带, 保留残端

Abstract: Objective:To investigate the Shortterm effectiveness and clinical significance of Arthroscopic anterior cruciate ligament anatomic single bundle  reconstruction with remnant preservation.Methods:The clinical data were retrospectively analyzed from 79 patients treated by arthroscopic anterior cruciate ligament anatomic single bundle reconstruction with remnant preservation between January 2012 and July 2016.they were divided into two groups according to handing stump.There were 38 patients with remnant preservation(RP) group and 41 patients with conventional group.Postoperative followup assessment included the Lachman test,pivot shift test and KT1000 measurement International Knee Documentation Committee(IKDC) grading ,Lysholm score,proprioception measurements.Results:All the patients were followed up for 12 months.At the time of 6 months after the operation,There were significant differences between the RP group and conventional group in Lachman test positive rate(10.5% vs.26.8%),pivot shift test positive rate (13.2% vs.29.2%)and proprioception evaluation measured with angle repetitive test[(3.56±1.73)°vs(4.84±1.85)°],There were no significant differences between groups in KT1000[(1.8±0.9)mm vs.(2.2±1.3)mm].At the time of 12 months after the operation,there were significant differences between the RP and conventional group in Lachman test positive rate(7.9% vs.21.9%),pivot shift test positive rate (7.9% vs.24.3%),KT1000[(1.2±0.8)mm vs.(1.7±1.0)mm],IKDC grading(cases with A gradings:81.6% vs.68.3%)and Lysholm score(96.4±3.1 vs.92.1±4.3)(P<0.05).There were no significant differences between groups in proprioception evaluation measured with angle repetitive test [(2.75±1.33)°vs.(3.28±1.51)°](P>0.05).Conclusion:The shortterm effectiveness of arthroscopic anterior cruciate ligament anatomic single bundle reconstruction in the treatment of ACL injury was fine.Arthroscopic ACL reconstruction combined with remnant preserved was benefited for the stability and proprioception of the knee,and the shortterm outcome was better.

Key words: arthroscopic, 〓anterior cruciate ligament, 〓remnantpreserved

[1] 税云华 诸源江 张兰 向继林. 收肌管联合闭孔神经阻滞对膝关节镜下前交叉韧带重建术病人镇痛效果及功能康复的影响[J]. 临床外科杂志, 2020, 28(9): 889-892.
[2] 韩俊, 刘国辉. 前交叉韧带止点撕脱性骨折关节镜下交叉不可吸收缝线固定与空芯螺钉固定的临床对比分析[J]. 临床外科杂志, 2019, 27(9): 788-790.
[3] 李勇, 高书明, 刘广飞, 王路, 卢守亮, 程才. 膝关节镜联合玻璃酸钠腔内注射在早期前交叉韧带重建术中的疗效分析[J]. 临床外科杂志, 2019, 27(4): 309-312.
[4] 佑​路标, 夏磊, 王龙等. 关节镜下自体腘绳肌腱重建前交叉韧带对老年急性前交叉韧带断裂病人膝关节肌力和位置觉的影响[J]. 临床外科杂志, 2019, 27(11): 995-998.
[5] 彭永海 张青松 李烨等 . 关节镜结合有限切开治疗膝关节多韧带损伤 [J]. 临床外科杂志, 2012, 20(11): 796-798.
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