文章摘要
李文凯,吴华,韦盛,等.关节镜下解剖位与过顶位前交叉韧带单束重建的近期疗效对比.骨科,2015,6(3): 113-116.
关节镜下解剖位与过顶位前交叉韧带单束重建的近期疗效对比
Anatomic versus conventional over-the-top single-bundle in arthroscopic reconstruction of anterior cruciate ligament
投稿时间:2014-09-18  
DOI:10.3969/j.issn.1674-8573.2015.03.001
中文关键词: 关节镜检查  前交叉韧带重建  膝关节  修复外科手术
英文关键词: Arthroscopy  Anterior cruciate ligament reconstruction  Knee joint  Reconstructive surgical procedures
基金项目:
作者单位E-mail
李文凯 430030 武汉华中科技大学同济医学院附属同济医院骨科  
吴华 430030 武汉华中科技大学同济医学院附属同济医院骨科  
韦盛 430030 武汉华中科技大学同济医学院附属同济医院骨科  
王威 430030 武汉华中科技大学同济医学院附属同济医院骨科  
游洪波 430030 武汉华中科技大学同济医学院附属同济医院骨科 hbyouwh@gmail.com 
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中文摘要:
      目的 比较关节镜下前交叉韧带(anterior cruciate ligament, ACL)解剖位单束(anatomic single-bundle, ASB)与传统过顶位单束(conventional over-the-top single-bundle, CSB)重建的近期临床疗效。方法 回顾分析2010年10月至2012年10月在我院关节外科接受ACL重建手术的病例及随访资料,按手术方式不同分为ASB组(n=31)和CSB组(n=32),移植韧带来源均为自体腘绳肌腱。比较两组患者在术后3~6个月的膝关节功能,评估方法采用膝关节主动活动度、Lachman试验、轴移试验、Lysholm评分及国际膝关节评分委员会(International Knee Documentation Committee, IKDC)评分。结果 术后膝关节主动活动度:CSB组3例术后膝关节伸直受限,平均5°~10°,ASB组无伸直受限,两组屈曲均正常;Lachman试验:ASB组全部阴性,CSB组6例阳性,差异有统计学意义(P<0.05);轴移试验:ASB组阴性率为67.74%,CSB组阴性率为40.63%,差异有统计学意义(P<0.05);Lysholm评分及IKDC评分差异均无统计学意义(均P>0.05)。结论 ACL的ASB重建术后早期能更好地恢复膝关节的前后及旋转稳定性,其临床意义及远期临床效果有待进一步研究。
英文摘要:
      Objective To compare the recent clinical results of the arthroscopic single-bundle ACL reconstruction with conventional over-the-top and anatomic insertions. Methods The curative results and follow-up data were retrospective analyzed in cases with ACL injure which were treated with ACL reconstruction in our hospital from Oct. 2010 to Oct. 2012. All cases were performed single-bundle reconstruction with autogeneic hamstring tendons and divided into 2 groups(CSB group and ASB group) according to surgical opinions. The knee functions after 3 to 6 months of operation were evaluated by active joint flexion degree, pivot shift test, Lachman test, IKDC and Lysholm scores. Results The active joint flexion degree: 3 cases presented 5°-10° extension limitation in CSB with no flexion limitation; no flexion limitation and extension limitation in ASB cases. Lachman test: all cases presented negative Lachman test in ASB while 6 positive in CSB. Negative pivot shift was 67.74% in ASB vs. 40.63% in CSB. There's no significance different between 2 groups on Lysholm and IKDC scores(all P>0.05). Conclusion ASB reconstruction resulted in better anteroposterior and rotational stability than CSB reconstruction. However, further follow-up clinical study are needed.
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