关节镜下前交叉韧带单束和双束个体化解剖重建临床疗效对比研究

发布时间：2018-06-19 19:12

本文选题：关节镜 + 前交叉韧带　；参考：《中华骨与关节外科杂志》2016年06期

【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乆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),移植物均使用自体乆绳肌腱。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(P0.05)。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(P0.05)。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。
[Abstract]:Background: rupture of anterior cruciate ligamentum anterior cruciate ligament is one of the most common injuries of knee joint, and conservative treatment is poor. In most young patients, surgical treatment is the best choice if they want to return to normal standard of living. Objective: to compare the clinical efficacy of single bundle and double bundle under arthroscopy in the reconstruction of ACL. Methods: the clinical and follow-up data of 720 patients with ACL reconstruction from October 2009 to May 2013 were retrospectively analyzed. All the patients underwent individualized reconstruction, which were divided into single bundle anatomical reconstruction (440 cases) and double bundle anatomical reconstruction (280 cases). Tibial-Intrafix and portal nail were used to fix the tibial bone canal in both groups, and the femoral bone canal was fixed with Endobutton. After operation, I K DCV Lysholm and Tegner scores were used to evaluate the subjective function of knee joint and Lachman test was used to evaluate the stability of KT-3000. Results the average follow-up time was 24.21 卤1.73 months. The scores of Lysholm IKDC and Tegner were improved significantly in both groups, but there was no significant difference between the two groups (P 0.05). The objective stability evaluation of the two groups was significantly higher than that before operation, but there was no significant difference between the two groups (P 0.05). Conclusion: compared with single bundle reconstruction, double bundle reconstruction has no obvious advantage in the postoperative IKDCU Lysholm score and KT-3000 measurement value, both single bundle and double bundle reconstruction can restore the stability and function of knee joint, and the short-term curative effect is satisfactory.
【作者单位】：深圳大学第一附属医院深圳市第二人民医院运动医学科;深圳市组织工程重点实验室;深圳市运动医学技术工程研究中心;
【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)
【分类号】：R687.4

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