关节镜下前交叉韧带保残重建1年随访

发布时间：2018-06-02 11:38

本文选题：前交叉韧带 + 膝关节　；参考：《皖南医学院》2015年硕士论文

【摘要】：目的:关节镜下前交叉韧带保残与非保残重建的优劣以及保残重建对本体感觉的影响尚无明确定论。大多数文章观点认为保残对修复后稳定性、主观功能评分、促进移植物愈合明显优于非保残组。本研究比较关节镜下前交叉韧带自体乆绳肌腱移植保残重建与非保残重建后膝关节功能及稳定性的1年随访,通过比较前交叉韧带保残重建与非保残重建在主观感受,Lysholm评分,IKDC评分及KT2000检测,本体感觉方面以及手术并发症方面是否存在显著差异,为今后临床工作选择更为合理的手术方式提供依据。方法:本研究回顾性分析某院自2010年9月至2013年7月在关节镜下进行前交叉韧带重建病例75例,均采用自体乆绳肌腱进行单束重建,其中非保残重建37例,保残重建38例,治疗前及治疗后6个月、治疗后1年进行Lysholm评分,IKDC评分及KT2000检测评价患者膝关节功能及稳定性,并采用被动角度重复试验进行本体感觉测试。本组前交叉韧带重建在胫骨骨道制备上进行了改良,以小于移植物直径1 mm的钻头做初始骨道,用骨道挫扩大骨道,可以将骨道位置进行二次微调,减少骨道位置偏差可能结果:治疗后随访时间为12-20个月。两组患者治疗后6个月患膝关节活动度均已基本恢复正常,患膝治疗后6个月、治疗后1年Lysholm评分,IKDC评分及KT2000检测较治疗前均获改善(P0.05),两组之间差异无显著性意义。术后6个月及1年保残组健侧和患侧本体感觉偏差小于非保残组(P0.05)。治疗后摄片检查发现两组各有2例患者胫骨骨道偏离理想位置,未见独眼畸形发生。结论:前交叉韧带自体乆绳肌腱移植保残重建有利于患者修复术后本体感觉的恢复,在术后稳定性及主观功能评分上无明显区别,并不增加手术并发症的发生率。该结论与多数文章得出的结论存在出入。
[Abstract]:Aim: there is no clear conclusion on the reconstruction of anterior cruciate ligament (ACL) under arthroscopy and its effect on proprioceptive perception. In most of the articles, the stability, subjective function score and graft healing were significantly better than those in the non-disabled group. The purpose of this study was to compare the function and stability of knee joint after arthroscopic reconstruction of anterior cruciate ligament (ACL) with or without tendon graft. By comparing anterior cruciate ligament reconstruction with non-preservation reconstruction, there were significant differences in subjective perception Lysholm score, IKDC score and KT2000, proprioceptive perception and surgical complications. To provide the basis for the choice of more reasonable surgical methods for clinical work in the future. Methods: from September 2010 to July 2013, 75 cases of anterior cruciate ligament (ACL) reconstruction under arthroscopy were retrospectively analyzed. The knee joint function and stability were evaluated by Lysholm score and KT2000 before treatment and 6 months after treatment, and the proprioceptive test was performed by passive angle repeat test. The anterior cruciate ligament (ACL) reconstruction was improved on the preparation of the tibial bone canal. With the drill less than 1 mm in diameter of the graft as the initial osseous canal, the bone canal was enlarged with the bone canal, and the position of the bone canal could be adjusted twice. The possible result of reducing the deviation of osseous tract position: the follow-up time was 12-20 months after treatment. After 6 months of treatment, the motion of knee joint in the two groups had basically returned to normal, and the Lysholm score and KT2000 were improved in 1 year after the treatment. There was no significant difference between the two groups. 6 months and 1 year after operation, the deviation of proprioceptive sensation between the healthy side and the affected side in the disabled group was lower than that in the non-disabled group (P 0.05). After treatment, two patients in each group were found to be deviated from the ideal position of tibial bone tract, and no uniocular malformation was found. Conclusion: the autograft of anterior cruciate ligament is beneficial to the recovery of proprioceptive sensation after repair. There is no significant difference in postoperative stability and subjective function score, and the incidence of complications is not increased. There is a discrepancy between this conclusion and that of most articles.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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