前交叉韧带早期重建术后股骨外侧髁压迹远期转归的相关研究
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作者Author单位AddressE-Mail
李明 LI Ming 浙江大学医学院附属第二医院嘉善分院 浙江省嘉善县第一人民医院, 浙江 嘉善 314100 Jiashan Branch of the Second Hospital Affiliated to Zhejiang University School of Medicine, Jiashan County First People's Hospital, Jiashan 314100, Zhejiang, China  
曹武 CAO Wu 浙江大学医学院附属第二医院嘉善分院 浙江省嘉善县第一人民医院, 浙江 嘉善 314100 Jiashan Branch of the Second Hospital Affiliated to Zhejiang University School of Medicine, Jiashan County First People's Hospital, Jiashan 314100, Zhejiang, China  
崔峻 CUI Jun 浙江大学医学院附属第二医院嘉善分院 浙江省嘉善县第一人民医院, 浙江 嘉善 314100 Jiashan Branch of the Second Hospital Affiliated to Zhejiang University School of Medicine, Jiashan County First People's Hospital, Jiashan 314100, Zhejiang, China  
楼崎良 LOU Qi-liang 浙江大学医学院附属第二医院嘉善分院 浙江省嘉善县第一人民医院, 浙江 嘉善 314100 Jiashan Branch of the Second Hospital Affiliated to Zhejiang University School of Medicine, Jiashan County First People's Hospital, Jiashan 314100, Zhejiang, China  
孙广臣 SUN Guang-chen 浙江大学医学院附属第二医院嘉善分院 浙江省嘉善县第一人民医院, 浙江 嘉善 314100 Jiashan Branch of the Second Hospital Affiliated to Zhejiang University School of Medicine, Jiashan County First People's Hospital, Jiashan 314100, Zhejiang, China lm447302396@163.com 
期刊信息:《中国骨伤》2023年,第36卷,第5期,第459-464页
DOI:10.12200/j.issn.1003-0034.2023.05.013
基金项目:
中文摘要:

目的:探讨前交叉韧带(anterior cruciate ligament,ACL)早期重建术后股骨外侧髁压迹(lateral femoral notch,LFN)的转归并评估术后膝关节功能恢复情况。

方法:对2015年12月至2019年12月间接受早期前交叉韧带重建的32例的临床资料进行回顾性分析,其中男18例,女14例,年龄16~54(25.39±2.82)岁;身体质量指数(body mass index,BMI)为20~30(26.15±3.09) kg/m2;交通伤6例,运动损伤19例,重物压伤7例。膝关节MRI显示所有患者损伤后LFN深度>1.5 mm,且术中对于LFN未进行干预。通过MRI资料观察患者手术前后的LFN缺损深度、面积及体积,对患者手术前后的国际软骨修复学会(International Cartilage Repair Society,ICRS)评分、Lysholm评分、Tegner活动水平、膝关节损伤和骨关节炎结局评分(knee injury and osteoarthritis outcome score,KOOS)进行分析。

结果: 32例患者随访时间为2~6(3.28±1.12)年。LFN缺损深度由术前的(2.31±0.67) mm至随访时的(2.53±0.50) mm,无明显变化(P=0.136);LFN缺损面积由(207.55±81.01) mm2减少至(171.36±52.69) mm2(P=0.038)。LFN缺损体积由(426.32±176.54) mm3减少至(340.86±151.54) mm3(P=0.042)。ICRS评分由(1.51±0.34)分增加至(2.92±0.33)分(P<0.001)。Lysholm评分由(35.37±10.54)分增加至(94.46±8.45)分(P<0.001)。Tegner运动评分由(3.45±0.94)分增加至(7.56±1.28)分(P<0.001)。末次随访KOOS评分为(90.42±16.35)分。

结论:随着前交叉韧带重建术后恢复时间的增加,LFN的缺损面积及体积逐渐减小,但缺陷深度不变。患者膝关节功能明显改善。LFN缺损处软骨有改善,但修复效果不佳。
【关键词】前叉韧带重建  股骨外侧髁压迹  关节镜  磁共振成像
 
Long-term outcomes of lateral femoral notch after early anterior cruciate ligament reconstruction
ABSTRACT  

Objective To investigate the outcome of lateral femoral notch (LFN) after early anterior cruciate ligament (ACL) reconstruction and evaluate the recovery of knee joint function after the operation.

Methods The clinical data of 32 patients who underwent early ACL reconstruction from December 2015 to December 2019 were retrospectively analyzed. The study included 18 males and 14 females,aged 16 to 54 years old,with an average age of (25.39±2.82) years. The body mass index (BMI) of the patients ranged from 20 to 30 kg/cm2,with an average of (26.15±3.09) kg/cm2. Among them,6 cases were caused by traffic accidents,19 by exercise,and 7 by the crush of heavy objects. MRI of all patients showed LFN depth was more than 1.5 mm after injury,and no intervention for LFN was performed during surgery. Preoperative and postoperative depth,area,and volume of LFN defects were observed by MRI data. International Cartilage Repair Society (ICRS) score,Lysholm score,Tegner activity levels,and knee injury and osteoarthritis outcome score (KOOS) were analyzed before and after the operation.

Results All patients were followed up from 2 to 6 years with an average of (3.28±1.12) years. There was no significant difference in the defect depth of LFN from (2.31±0.67) mm before the operation to (2.53±0.50) mm at follow-up (P=0.136). The defect area of LFN was decreased from (207.55±81.01)mm2 to (171.36±52.69)mm2 (P=0.038),and the defect volume of LFN was decreased from (426.32±176.54) mm3 to (340.86±151.54)mm3 (P=0.042). The ICRS score increased from (1.51±0.34) to (2.92±0.33) (P<0.001),the Lysholm score increased from (35.37±10.54) to (94.46±8.45) (P<0.001),and the Tegner motor score increased from (3.45±0.94) to (7.56±1.28),which was significantly higher than that of the preoperative data (P<0.001). The KOOS score of the final follow-up was 90.42±16.35.

Conclusion With the increase of recovery time after anterior cruciate ligament reconstruction,the defect area and volume of LFN decreased gradually,but the defect depth remained unchanged. The knee joint function of the patients significantly improved. The cartilage of the LFN defect improved,but the repair effect was not good.
KEY WORDS  Anterior cruciate ligament reconstruction  Lateral femoral notch  Arthroscopy  Magnetic resonance imaging
 
引用本文,请按以下格式著录参考文献:
中文格式:李明,曹武,崔峻,楼崎良,孙广臣.前交叉韧带早期重建术后股骨外侧髁压迹远期转归的相关研究[J].中国骨伤,2023,36(5):459~464
英文格式:LI Ming,CAO Wu,CUI Jun,LOU Qi-liang,SUN Guang-chen.Long-term outcomes of lateral femoral notch after early anterior cruciate ligament reconstruction[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(5):459~464
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