摘要
背景:前交叉韧带(anterior cruciate ligament,ACL)断裂是膝关节最常见的损伤之一,保守治疗疗效欠佳;在大多数年轻患者中,若想恢复到正常生活水平,手术治疗是最好的选择。目的:比较关节镜下单束和双束腘绳肌腱个体化解剖重建ACL的临床疗效。方法:回顾性分析2009年10月至2013年5月,共720例初次前交叉韧带断裂在我科接受ACL重建术的患者的临床及随访资料。所有患者均采取个体化重建,手术方式分为单束解剖重建(440例)及双束解剖重建(280例),移植物均使用自体腘绳肌腱。两组胫骨骨道均用Tibial-Intrafix及门型钉双重固定,股骨骨道用Endobutton固定。术后随访采用IKDC、Lysholm和Tegner评分进行膝关节主观功能评价,Lachman试验、轴移试验、KT-3000测量客观评估稳定性。结果:720例患者均获随访,平均随访时间(24.21±1.73)个月。两组术后Lysholm、IKDC和Tegner功能评分较术前均显著改善,但组间无显著性差异(P>0.05)。两组术后客观稳定性评估较术前均显著提高,但组间差异无统计学意义(P>0.05)。结论:与单束重建对比,双束重建在术后膝关节IKDC、Lysholm评分结果及KT-3000测量值上没有明显优势;单束及双束重建均能很好地恢复膝关节的稳定性及功能,近期疗效满意。
Background： Rupture of the anterior cruciate ligament（ACL） is one of the most common knee injuries. Due to the unsatisfactory outcomes of conservative treatment for ACL injuries,reconstruction surgery remains the treatment of choice in most young patients who want to maintain an active lifestyle. Objective： To investigate the clinical outcome of single-bundle versus double-bundle individually anatomic ACL reconstructions. Methods： Totally 720 patients undergoing arthroscopic ACL anatomic reconstruction from October 2009 to May 2013 were enrolled in this retrospective study. They were assigned to single-bundle group（n=440） and double-bundle group（n=280） according to surgical procedures. Hamstring tendon autograft was used in all the patients. Femoral Endobutton was used to fix the graft at the femoral site. TibialIntrafix was used to fix the graft at the tibial site. Postoperative assessment included the International Knee Documentation Committee（IKDC） score,Lysholm and Tegner scores,Lachman test,pivot shift test and KT-3000 measurement. Results：The mean duration of follow-up was（24.21 ± 1.73） months in all the 720 patients. The IKDC,Lysholm and Tegner scores were significantly improved after surgery in both groups,but no significant difference was found between groups（P〉0.05）.Conclusions： The results of KT-3000,Lachman test and pivot shift test and the scores of IKDC,Lysholm and Tegner in double-bundle ACL reconstruction are not significantly different from those in single-bundle ACL reconstruction. Both singlebundle and double-bundle ACL reconstructions with hamstring tendon autograft can restore the knee stability and functional outcomes well and achieve satisfactory short-term clinical outcome.
出处
《中国骨与关节外科》
2016年第6期484-488,共5页
Chinese Journal of Bone and Joint Surgery
基金
广东省科技计划项目(编号:2015A020212001
2013B021800100)
深圳市科技计划项目(编号:JCYJ20140414170821164)
关键词
关节镜
前交叉韧带
个体化
解剖重建
临床疗效
Arthroscopy
Anterior Cruciate Ligament
Individualization
Anatomic Reconstruction
Clinical Outcome
