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[1]姚五平,邢濤,李磊,等.前交叉韌帶部分損傷后關(guān)節(jié)鏡下保留殘束 重建與單束重建的對比研究[J].中醫(yī)正骨,2015,27(12):24-28.
　YAO Wuping,XING Tao,LI Lei,et al.A retrospective trial of arthroscopic reconstruction with residual-bundle reserved versus single-bundle reconstruction for treatment of anterior cruciate ligament partial injury[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):24-28.
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前交叉韌帶部分損傷后關(guān)節(jié)鏡下保留殘束 重建與單束重建的對比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年12期
頁碼:
24-28
欄目:
臨床研究
出版日期:
2015-12-30

文章信息/Info

Title:
A retrospective trial of arthroscopic reconstruction with residual-bundle reserved versus single-bundle reconstruction for treatment of anterior cruciate ligament partial injury
作者:
姚五平1; 邢濤1; 李磊2; 何勇1; 王鵬1; 姚柳伊1
1.甘肅省中醫(yī)院,甘肅 蘭州 730050;
2.福建中醫(yī)藥大學(xué),福建 福州 350100
Author(s):
YAO Wuping1; XING Tao1; LI Lei2; HE Yong1; WANG Peng1; YAO Liuyi1
1.Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,Gansu,China
2.Fujian University of Traditional Chinese Medicine,Fuzhou 350100,Fujian,China
關(guān)鍵詞:
前交叉韌帶;  前交叉韌帶重建;  關(guān)節(jié)鏡檢查;  治療; 臨床研究性
Keywords:
words anterior cruciate ligament;  anterior cruciate ligament reconstruction;  arthroscopy;  therapies; investigational
摘要:
目的:比較前交叉韌帶部分損傷后關(guān)節(jié)鏡下保留殘束重建與單束重建的臨床療效。方法:回顧性分析73例前交叉韌帶部分損傷患者的病例資料,其中關(guān)節(jié)鏡下保留殘束重建31例,單束重建42例。男47例,女26例。年齡18～51歲,中位數(shù)29歲。左膝39例,右膝34例。受傷至手術(shù)時間4 d至17個月,中位數(shù)1個月。分別比較術(shù)前及術(shù)后12個月2組患者的國際膝關(guān)節(jié)文獻(xiàn)委員會(international knee documentation committee,IKDC)評分、Tegner膝關(guān)節(jié)運(yùn)動評分和Lysholm膝關(guān)節(jié)功能評分,并比較術(shù)后12個月2組患者于屈膝30°和屈膝90°時雙膝脛骨前移距離差值。結(jié)果:①IKDC評分。術(shù)前及術(shù)后12個月單束重建組和保留殘束重建組患者IKDC評分比較,組間差異均無統(tǒng)計學(xué)意義[(48.23±24.21)分,(38.26±18.35)分,t=0.752,P=0.426;(91.12±8.75)分,(94.12±7.23)分,t=0.845,P=0.513]; 術(shù)后12個月2組患者IKDC評分均高于術(shù)前(t=0.423,P=0.001; t=0.579,P=0.004)。②Tegner膝關(guān)節(jié)運(yùn)動評分。術(shù)前及術(shù)后12個月2組患者Tegner膝關(guān)節(jié)運(yùn)動評分比較,組間差異均無統(tǒng)計學(xué)意義[(52.45±28.97)分,(47.24±27.89)分,t=0.491,P=0.501;(94.21±5.51)分,(95.61±2.98)分,t=0.780,P=0.146]; 術(shù)后12個月2組患者Tegner膝關(guān)節(jié)運(yùn)動評分均高于術(shù)前(t=0.213,P=0.000; t=0.458,P=0.007)。③Lysholm膝關(guān)節(jié)功能評分。術(shù)前及術(shù)后12個月2組患者Lysholm膝關(guān)節(jié)功能評分比較,組間差異均無統(tǒng)計學(xué)意義[(3.06±2.31)分,(2.76±2.68)分,t=0.813,P=0.079;(7.15±1.70)分,(7.45±1.72)分,t=0.851,P=0.124]; 術(shù)后12個月2組患者Lysholm膝關(guān)節(jié)功能評分均高于術(shù)前(t=0.741,P=0.006; t=0.193,P=0.000)。④雙膝脛骨前移距離差值。術(shù)后12個月屈膝30°(15磅、20磅、30磅)和屈膝90°(15磅、20磅、30磅)時單束重建組患者的雙膝脛骨前移距離差值均大于保留殘束重建組[(1.51±1.52)mm,(0.54±1.01)mm,t=0.127,P=0.013;(1.92±1.57)mm,(0.74±1.04)mm,t=0.226,P=0.001;(2.23±1.32)mm,(1.35±1.26)mm,t=0.121,P=0.012;(0.97±1.24)mm,(0.42±0.76)mm,t=0.452,P=0.021;(0.97±1.68)mm,(0.34±1.02)mm,t=0.521,P=0.016;(1.25±1.49)mm,(0.53±1.26)mm,t=0.530,P=0.012]。結(jié)論:關(guān)節(jié)鏡下保留殘束重建和單束重建修復(fù)ACL部分損傷,均能獲得滿意的膝關(guān)節(jié)功能,但是保留殘束重建較單束重建能夠提供更好的膝關(guān)節(jié)穩(wěn)定性。
Abstract:
Objective:To compare the clinical curative effects of arthroscopic anterior cruciate ligament(ACL)reconstruction with residual-bundle reserved versus single-bundle reconstruction for treatment of ACL partial injury.Methods:The medical records of 73 patients with ACL partial injury who were treated with arthroscopic ACL reconstruction with residual-bundle reserved(31)and single-bundle reconstruction(42)were analyzed retrospectively.The patients consisted of 47 males and 26 females,and ranged in age from 18 to 51 years(median=29 yrs),and ranged in disease course from 4 days to 17 months(Median=1 month).The ACL partial injury located in left knee for 39 patients and right knee for 34 patients.International knee documentation committee(IKDC)score,Tegner knee movement score and Lysholm knee functional score were compared between the two groups before the surgery and at 12 months after the surgery respectively,and the difference in antedisplacement distance between bilateral tibia were also compared between the two groups when the knee was bent into a angle of 30 and 90 degrees at 12 months after the surgery.Results:There was no statistical difference in IKDC scores between the 2 groups before the surgery and at 12 months after the surgery(48.23+/-24.21 vs 38.26+/-18.35 points,t=0.752,P=0.426; 91.12+/-8.75 vs 94.12+/-7.23 points,t=0.845,P=0.513).The IKDC scores of the 2 groups were higher at 12 months after the surgery compared to pre-surgery(t=0.423,P=0.001; t=0.579,P=0.004).There was no statistical difference in Tegner knee movement scores between the 2 groups before the surgery and at 12 months after the surgery(52.45+/-28.97 vs 47.24+/-27.89 points,t=0.491,P=0.501; 94.21+/-5.51 vs 95.61+/-2.98 points,t=0.780,P=0.146).The Tegner knee movement scores of the 2 groups were higher at 12 months after the surgery compared to pre-surgery(t=0.213,P=0.000; t=0.458,P=0.007).There was no statistical difference in Lysholm knee functional scores between the 2 groups before the surgery and at 12 months after the surgery(3.06+/-2.31 vs 2.76+/-2.68 points,t=0.813,P=0.079; 7.15+/-1.70 vs 7.45+/-1.72 points,t=0.851,P=0.124).The Lysholm knee functional scores of the 2 groups were higher at 12 months after the surgery compared to pre-surgery(t=0.741,P=0.006; t=0.193,P=0.000).The difference in antedisplacement distance between bilateral tibia were greater in single-bundle reconstruction group compared to residual-bundle reconstruction group when the knee was bent into a angle of 30 degrees(15,20 and 30 pounds)and 90 degrees(15,20 and 30 pounds)at 12 months after the surgery(1.51+/-1.52 vs 0.54+/-1.01 mm,t=0.127,P=0.013; 1.92+/-1.57 vs 0.74+/-1.04 mm,t=0.226,P=0.001; 2.23+/-1.32 vs 1.35+/-1.26 mm,t=0.121,P=0.012; 0.97+/-1.24 vs 0.42+/-0.76 mm,t=0.452,P=0.021; 0.97+/-1.68 vs 0.34+/-1.02 mm,t=0.521,P=0.016; 1.25+/-1.49 vs 0.53+/-1.26 mm,t=0.530,P=0.012).Conclusion:Satisfactory knee function can be obtained by arthroscopic ACL reconstruction with residual-bundle reserved or single-bundle reconstruction in the treatment of ACL partial injury,while the former surpasses the latter in knee stability.

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備注/Memo

備注/Memo:
2015-09-01收稿 2015-10-11修回
通訊作者:邢濤 E-mail:[email protected]
更新日期/Last Update: 2015-12-30