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保残与非保残重建后交叉韧带的病例对照研究
Hits: 2294   Download times: 1589   Received:March 11, 2013    
作者Author单位UnitE-Mail
王军 WANG Jun 潍坊市人民医院关节外科, 山东 潍坊 261041 Department of Joint Surgery, People's Hospital of Weifang, Weifang 261041, Shandong, China  
姜鑫 JIANG Xin 潍坊市人民医院关节外科, 山东 潍坊 261041 Department of Joint Surgery, People's Hospital of Weifang, Weifang 261041, Shandong, China wfjiangx001@sina.com 
张益民 ZHANG Yi-min 潍坊市人民医院关节外科, 山东 潍坊 261041 Department of Joint Surgery, People's Hospital of Weifang, Weifang 261041, Shandong, China  
郭永智 GUO Yong-zhi 潍坊市人民医院关节外科, 山东 潍坊 261041 Department of Joint Surgery, People's Hospital of Weifang, Weifang 261041, Shandong, China  
期刊信息:《中国骨伤》2013年26卷,第5期,第365-369页
DOI:10.3969/j.issn.1003-0034.2013.05.003


目的: 探讨关节镜下保留残端纤维与非保留残端重建后交叉韧带的方法与疗效。

方法: 2006年1月至2011年1月, 在关节镜下自体腘绳肌腱重建后交叉韧带45例, 可吸收挤压螺钉固定移植物。非保残技术重建后交叉韧带25例, 男19例, 女6例;清理断端后胫骨骨道采用双螺钉全骨隧道固定技术。保留残端重建后交叉韧带20例, 男15例, 女5例;保留残端纤维, 采用与非保残组同样的固定方法。两组均随访18个月, 采用KT-2000胫骨后移距离、Lysholm膝关节评分、IKDC评分及分级进行疗效评定。

结果: 在术后18个月随访时, KT-2000测胫骨后移距离、Lysholm 膝关节评分及IKDC评分, 非保残重建组分别为(4.2±2.1) mm,84.3±10.5和64.5±8.8;保残组(3.9±1.8) mm,86.5±8.9和68.6±7.9,两组差异无统计学意义。IKDC运动能力分级恢复正常或基本正常者, 保残组优于非保残组。

结论: 保留残端纤维关节镜下后交叉韧带重建, 在恢复膝关节运动功能方面显示了较非保残重建更好的优势。
[关键词]:后交叉韧带  膝关节  修复外科手术  关节镜  病例对照研究
 
Case-control studies on clinical effects of non- and remnant preservation for reconstruction of posterior cruciate ligament
Abstract:

Objective: To evaluate the methods and therapeutic effects of the posterior cruciate ligament(PCL) reconstruction with remnant preservation and no preservation.

Methods: From January 2006 to January 2011,45 patients received arthroscopic PCL reconstruction by using hamstring tendon autograft fixed with bioabsorbable interference screw. Twenty-five patients were treated with PCL reconstruction with remnant no preservation,including 19 males and 6 females. During the operation,remnant PCL was not preserved,double-screws and whole-bone-tunnel technique was used to fix the tibial side. Twenty patients were treated with PCL reconstruction with remnant preservation,including 15 males and 5 females. Although the fixation technique was similar to the remnant no preservation group,the remnant was preserved. All the patients were followed up with a mean period of 18 months. Each patient was evaluated using the following variables:posterior laxity on KT-2000,Lysholm knee score,International Knee Documentation Committee (IKDC) knee score and grade.

Results: At the latest follow-up,the results of mean side-to-side differences in posterior tibial translation,Lysholm knee score and IKDC score were (4.2±2.1) mm,84.3±10.5 and 64.5±8.8 in the remnant no preservation group separately,and (3.9±1.8) mm,86.5±8.9 and 68.6±7.9 in the remnant preservation group separately. There were no statistical differences of above results between the two groups. However,IKDC objective grade differed significantly between the two groups and the result in remnant preservation group was better than that of remnant no preservation group.

Conclusion: Remnant preservation in PCL reconstruction can provide better activity-related outcomes than remnant no preservation.
KEYWORDS:Posterior cruciate ligament  Knee joint  Reconstructive surgical procedures  Arthroscopes  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:王军,姜鑫,张益民,郭永智.保残与非保残重建后交叉韧带的病例对照研究[J].中国骨伤,2013,26(5):365~369
英文格式:WANG Jun,JIANG Xin,ZHANG Yi-min,GUO Yong-zhi.Case-control studies on clinical effects of non- and remnant preservation for reconstruction of posterior cruciate ligament[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(5):365~369
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