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[1]張思遠(yuǎn),林武杰,郭文煊,等.同種異體肌腱微創(chuàng)解剖重建踝關(guān)節(jié)外側(cè)韌帶治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)[J].中醫(yī)正骨,2022,34(08):69-72.
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同種異體肌腱微創(chuàng)解剖重建踝關(guān)節(jié)外側(cè)韌帶治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年08期
頁(yè)碼:
69-72
欄目:
臨床報(bào)道
出版日期:
2022-08-20

文章信息/Info

作者:
張思遠(yuǎn)1林武杰2郭文煊1吳向科3莊汝杰4
(1.浙江中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院,浙江 杭州 310053; 2.臺(tái)州市黃巖區(qū)中醫(yī)院,浙江 臺(tái)州 318020; 3.浙江中醫(yī)藥大學(xué)附屬四省邊際中醫(yī)院,浙江 衢州 324002; 4.浙江省中醫(yī)院,浙江 杭州 310006)
關(guān)鍵詞:
外側(cè)韌帶 慢性踝關(guān)節(jié)外側(cè)不穩(wěn) 同種異體肌腱移植 步態(tài)分析
摘要:
目的:觀察同種異體肌腱微創(chuàng)解剖重建踝關(guān)節(jié)外側(cè)韌帶治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)的臨床療效。方法:2019年3月至2021年3月收治32例慢性踝關(guān)節(jié)外側(cè)不穩(wěn)患者。男14例,女18例。年齡21~68歲,中位數(shù)41歲。左側(cè)17例,右側(cè)15例。踝關(guān)節(jié)MRI檢查顯示,所有患者均存在距腓前韌帶斷裂,其中3例合并跟腓韌帶損傷。病程7~18個(gè)月,中位數(shù)12個(gè)月。均先在關(guān)節(jié)鏡下探查清理,然后根據(jù)踝關(guān)節(jié)外側(cè)韌帶損傷情況,以同種異體肌腱單獨(dú)重建距腓前韌帶或同時(shí)重建距腓前韌帶和跟腓韌帶。采用視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)價(jià)踝關(guān)節(jié)疼痛情況,采用美國(guó)足與踝關(guān)節(jié)協(xié)會(huì)(American Orthopedic Foot and Ankle Society,AOFAS)踝與后足評(píng)分量表和三維步態(tài)分析系統(tǒng)評(píng)價(jià)踝關(guān)節(jié)功能,三維步態(tài)分析系統(tǒng)測(cè)定的指標(biāo)包括垂直地反力峰值、單支撐相百分比及踝關(guān)節(jié)最大背伸角度。結(jié)果:患者均順利完成手術(shù)。所有患者均獲隨訪,隨訪時(shí)間3~12個(gè)月,中位數(shù)6個(gè)月。切口均甲級(jí)愈合。術(shù)后3個(gè)月時(shí),患者的踝關(guān)節(jié)疼痛VAS評(píng)分較術(shù)前降低[(4.50±0.73)分,(0.50±0.64)分,t=43.181,P=0.000],AOFAS踝與后足評(píng)分、垂直地反力峰值、單支撐相百分比及踝關(guān)節(jié)最大背伸角度均較術(shù)前增大[(63.62±2.2)分,(94.09±1.69)分,t=-55.971,P=0.000;(1.13±0.06)N·kg-1,(1.26±0.05)N·kg-1,t=-20.238,P=0.000;(34.79±1.17)%,(39.76±1.37)%,t=-24.637,P=0.000; 11.30°±1.03°,13.91°±1.43°,t=-20.678,P=0.000]。結(jié)論:同種異體肌腱微創(chuàng)解剖重建踝關(guān)節(jié)外側(cè)韌帶治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn),短期內(nèi)可有效緩解踝關(guān)節(jié)疼痛癥狀、改善踝關(guān)節(jié)功能。

參考文獻(xiàn)/References:

[1] DEJONG A F,KOLDENHOVEN R M,HERTEL J.Proximal adaptations in chronic ankle instability:systematic review and meta-analysis[J].Med Sci Sports Exerc,2020,52(7):1563-1575.
[2] MICHELS F,PEREIRA H,CALDER J,et al.Searching for consensus in the approach to patients with chronic lateral ankle instability:ask the expert[J].Knee Surg Sports Traumatol Arthrosc,2018,26(7):2095-2102.
[3] 劉曉華,石慧生,張磊,等.兩種腓骨側(cè)固定踝外側(cè)韌帶復(fù)合體重建的比較[J].中國(guó)矯形外科雜志,2021,29(22):2027-2031.
[4] KITAOKA H B,ALEXANDER I J,ADELAAR R S,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux,and lesser toes[J].Foot Ankle Int,1994,15(7):349-353.
[5] CRUZ-DÍAZ D,LOMAS VEGA R,OSUNA-PéREZ M C,et al.Effects of joint mobilization on chronic ankle instability:a randomized controlled trial[J].Disabil Rehabil,2015,37(7):601-610.
[6] BRANDÃO J S,ALVARENGA M L,PFEIFER J,et al.Allogeneic mesenchymal stem cell transplantation in healthy equine superficial digital flexor tendon:a study of the local inflammatory response[J].Res Vet Sci,2018,118:423-430.
[7] LUI P P,KONG S K,LAU P M,et al.Allogeneic tendon-derived stem cells promote tendon healing and suppress immunoreactions in hosts:in vivo model[J].Tissue Eng Part A,2014,20(21/22):2998-3009.
[8] DINIZ P,PACHECO J,FLORA M,et al.Clinical applications of allografts in foot and ankle surgery[J].Knee Surg Sports Traumatol Arthrosc,2019,27(6):1847-1872.
[9] CAREY J L,DUNN W R,DAHM D L,et al.A systematic review of anterior cruciate ligament reconstruction with autograft compared with allograft[J].J Bone Joint Surg Am,2009,91(9):2242-2250.
[10] NAKATA K,SHINO K,HORIBE S,et al.Reconstruction of the lateral ligaments of the ankle using solvent-dried and gamma-irradiated allogeneic fascia lata[J].J Bone Joint Surg Br,2000,82(4):579-582.
[11] WANG C W,MUHEREMU A,BAI J P.Use of three-dimensional finite element models of the lateral ankle ligaments to evaluate three surgical techniques[J].J Int Med Res,2018,46(2):699-709.
[12] 丁文鴿,李歡,王珂杰,等.采用同種異體肌腱重建踝關(guān)節(jié)外側(cè)韌帶微創(chuàng)治療慢性踝關(guān)節(jié)不穩(wěn)[J].中國(guó)骨與關(guān)節(jié)損傷雜志,2014,29(12):1291-1292.
[13] GIANNINI S,RUFFILLI A,PAGLIAZZI G,et al.Treatment algorithm for chronic lateral ankle instability[J].Muscles Ligaments Tendons J,2014,4(4):455-460.
[14] 錢文強(qiáng),林武杰,程爵富,等.步態(tài)分析在慢性踝關(guān)節(jié)不穩(wěn)診療中的應(yīng)用進(jìn)展[J].中醫(yī)正骨,2021,33(9):54-55.
[15] DELAHUNT E,MONAGHAN K,CAULFIELD B.Changes in lower limb kinematics,kinetics,and muscle activity in subjects with functional instability of the ankle joint during a single leg drop jump[J].J Orthop Res,2006,24(10):1991-2000.
[16] SON S J,KIM H,SEELEY M K,et al.Altered walking neuromechanics in patients with chronic ankle instability[J].J Athl Train,2019,54(6):684-697.
[17] SUGIMOTO K,TAKAKURA Y,OKAHASHI K,et al.Chondral injuries of the ankle with recurrent lateral instability:an arthroscopic study[J].J Bone Joint Surg Am,2009,91(1):99-106.
[18] 勞克誠(chéng),宋春雷,滕學(xué)仁,等.微創(chuàng)取部分腓骨短肌腱手術(shù)治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)的臨床療效[J].中國(guó)骨與關(guān)節(jié)損傷雜志,2017,32(6):649-650.
[19] LAN S,ZENG W,YUAN G,et al.All-inside arthroscopic anterior talofibular ligament anatomic reconstruction with a gracilis tendon autograft for chronic ankle instability in high-demand patients[J].J Foot Ankle Surg,2020,59(2):222-230.
[20] COTTOM J M,BAKER J,PLEMMONS B S.Analysis of two different arthroscopic broström repair constructs for treatment of chronic lateral ankle instability in 110 patients:a retrospective cohort study[J].J Foot Ankle Surg,2018,57(1):31-37.
[21] COTTOM J M,RICHARDSON P E.The “all-inside”arthroscopic broström procedure augmented with a proximal suture anchor:an innovative technique[J].J Foot Ankle Surg,2017,56(2):408-411.

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備注/Memo

備注/Memo:
基金項(xiàng)目:浙江中醫(yī)藥大學(xué)附屬醫(yī)院科研專項(xiàng)(2021FSYYZZ09) 通訊作者:莊汝杰 E-mail:[email protected]
更新日期/Last Update: 1900-01-01