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全内保残技术与标准化重建技术在前交叉韧带重建中的疗效比较
Hits: 648   Download times: 224   Received:March 27, 2023    
作者Author单位UnitE-Mail
金文铭 JIN Wen-ming 中国医科大学北部战区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Northern Theater Command General Hospital, Chinese Medical University, Shenyang 110016, Liaoning, China  
李宝 LI Bao 大连医科大学北部战区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Northern Theater Command General Hospital, Dalian Medical University, Shenyang 110016, Liaoning, China  
赵根 ZHAO Gen 大连医科大学北部战区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Northern Theater Command General Hospital, Dalian Medical University, Shenyang 110016, Liaoning, China  
李涵 LI Han 大连医科大学北部战区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Northern Theater Command General Hospital, Dalian Medical University, Shenyang 110016, Liaoning, China  
刘欣伟 LIU Xin-wei 中国医科大学北部战区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Northern Theater Command General Hospital, Chinese Medical University, Shenyang 110016, Liaoning, China liuxinweils@126.com 
期刊信息:《中国骨伤》2024年37卷,第1期,第45-50页
DOI:10.12200/j.issn.1003-0034.20221282
基金项目:沈阳联勤保障中心自选科研项目(编号:2020-485)


目的:探讨前交叉韧带重建手术中全内保残技术的疗效和临床结果。

方法:回顾性分析2018年1月至2019年12月收治的56例行前交叉韧带重建手术的病例。根据手术方式不同分为全内重建组和标准胫骨隧道组,全内重建组21例,男15例,女6例,年龄20~48(35.6±6.7)岁;标准胫骨隧道组35例,男26例,女9例,年龄22~51(33.7±9.6)岁。术前查体Lachman试验阳性,磁共振均提示前交叉韧带断裂。比较两组手术时间、编织后移植肌腱的长度及直径,术后1、2年国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分、Lysholm评分、Tegner评分和围手术期相关并发症。

结果:两组患者均获随访,时间24~30(26.9±3.4)个月。术后切口愈合良好,末次随访时未出现失效或关节感染病例。两组手术时间、韧带直径、韧带长度等一般资料比较,差异无统计学意义(P>0.05)。两组术前,术后1、2年IKDC评分、Lysholm评分、Tegner评分比较,差异无统计学意义(P>0.05),但术后1、2年IKDC评分、Lysholm评分、Tegner评分均高于术前(P<0.05)。

结论:在前交叉韧带重建手术中,采用保残全内技术和标准化重建技术都能获得相似的术后功能及膝关节稳定性,但是相比于标准化重建方式,保残全内组只取半腱肌,保留股薄肌,更大地保留胫骨侧骨量。
[关键词]:前交叉韧带  全内重建技术  标准重建技术  保残重建  膝关节镜
 
Retrospective analysis and comparison of total internal disability preservation technique and standardized reconstruction technique
Abstract:

Objective To investigate the efficacy and clinical results of total internal protection technique in anterior cruciate ligament reconstruction.

Methods A total of 56 patients undergoing anterior cruciate ligament reconstruction treated from January 2018 to December 2019 were selected. According to the different surgical methods,they were divided into total internal reconstruction group and standard bone tunnel group. There were 21 patients in the total internal reconstruction group,including 15 males and 6 females,aged from 20 to 48 with an average of (35.6±6.7) years old,and 35 patients in the standard tibial tunnel group,including 26 males and 9 females,aged 22 to 51 years old with an average of (33.7±9.6) years old. Preoperative examination of Lachman test was positive,magnetic resonance indicated anterior cruciate ligament rupture. There were no significant differences between the two groups in age,sex,body mass index,time from injury to ACL reconstruction,combined meniscus injury and operation method,operation time,ligament diameter,ligament length and other general information. Postoperative evaluation included operation duration,length and diameter of transplanted tendon after braid. International Knee Documentation Committee (IKDC) score,Lysholm score,Tegner score and perioperative complications 2 years after surgery.

Results Both groups were followed up,ranging from 24 to 30 months with an average of (26.9±3.4) months. Postoperative incision healing was good,and no failure or joint infection occurred at the last follow-up. There was no statistically significant difference between the two groups in IKDC score,Lysholm score and Tegner score before,1 year and 2 years after surgery. However,IKDC score,Lysholm score and Tegner score at 1 year and 2 years after surgery.

Conclusion The same postoperative function and stability of knee joint can be obtained by both the residual whole technique and the standardized reconstruction technique. In the residual whole group,only the semitendinosus muscle is taken,and the femoral thin muscle is retained,with greater tibial bone mass preserved,which is safe and effective in clinical practice.
KEYWORDS:Anterior cruciate ligament  Total internal reconstruction technique  Standard reconstruction technique  Disability protection and reconstruction  Knee arthroscopy
 
引用本文,请按以下格式著录参考文献:
中文格式:金文铭,李宝,赵根,李涵,刘欣伟.全内保残技术与标准化重建技术在前交叉韧带重建中的疗效比较[J].中国骨伤,2024,37(1):45~50
英文格式:JIN Wen-ming,LI Bao,ZHAO Gen,LI Han,LIU Xin-wei.Retrospective analysis and comparison of total internal disability preservation technique and standardized reconstruction technique[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(1):45~50
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