| 前交叉韧带双束双隧道增强重建术治疗膝关节前交叉韧带损伤的临床疗效 |
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Received:November 25, 2023
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李宝 |
LI Bao |
中国医科大学研究生院, 辽宁 沈阳 110000
北部战区总医院骨科, 辽宁 沈阳 110016 |
Graduate School of China Medical University, Shenyang 110000, Liaoning, China
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 刘欣伟 |
LIU Xin-wei |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 孙扬 |
SUN Yang |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 孙宁 |
SUN Ning |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 王宇 |
WANG Yu |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 段英超 |
DUAN Ying-chao |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 崔向红 |
CUI Xiang-hong |
大连康复疗养中心, 辽宁 大连 116000 |
Dalian Rehabilitation Center, Dalian 116000, Liaoning, China |
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| 孙乙鹏 |
SUN Yi-peng |
大连康复疗养中心, 辽宁 大连 116000 |
Dalian Rehabilitation Center, Dalian 116000, Liaoning, China |
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| 元红 |
YUAN Hong |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
1029214474@qq.com |
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| 期刊信息：《中国骨伤》2024年37卷，第7期，第649-654页 |
| DOI：10.12200/j.issn.1003-0034.20230576 |
| 基金项目:辽宁省科学技术计划(编号:2022-YGJC-07) |
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目的：探讨前交叉韧带(anterior cruciate ligament,ACL)双束双隧道增强重建技术在治疗膝关节 ACL 训练伤的临床应用疗效。
方法：回顾性分析自 2021 年 1 月至 2021 年 12 月诊治的膝关节 ACL 损伤患者 29 例均行韧带重建手术。按手术方法不同进行分组:传统重建组 14 例,男 13 例,女 1 例;年龄 22~31(27.07±7.28)岁;取自体腘绳肌腱行韧带重建。增强重建组 15 例,男 13 例,女 2 例,年龄 25~34(29.06±4.23)岁;双隧道韧带重建,取自体腘绳肌作为前内侧束,后外侧束用高强线替代。记录术前及术后第 6、12 个月膝关节胫骨前移距离差值、Lysholm 评分、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)主观评分、Tegner 运动水平评分和疼痛视觉模拟量表(visual analogue scale,VAS)、末次随访时的肢体对称指数(limb symmetry index,LSI)和随访期间出现的手术相关不良反应。
结果：全部患者获得随访,时间 13~15(13.7±0.8)个月,均未见手术相关严重不良反应的发生。增强重建组术后第 6、12 个月胫骨前移距离差值[(1.45±0.62)、(1.74±0.78) mm]低于传统重建组[(2.42±0.60)、(2.51±0.63) mm],P<0.05。两组术后 Lysholm、Tegner 运动水平、IKDC 评分、VAS 及末次随访时的肢体对称指数比较,差异均无统计学意义(P>0.05)。
结论：相比于传统韧带重建技术,增强重建技术更能有效维持膝关节的稳定性且对术后膝关节功能无显著影响,短期疗效令人满意,适用于运动需求较高的群体。 |
| [关键词]:膝关节 军事训练伤 关节镜 前交叉韧带 康复 |
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| Clinical efficacy of double-bundle and double-tunnel enhanced reconstruction in the treatment of anterior cruciate ligament injury |
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Abstract:
Objective To explore the clinical efficacy of double beam double-tunnel enhanced reconstruction technique in the treatment of knee anterior cruciate ligament (ACL) training injuries.
Methods Twenty-nine cases of ACL injury of knee joint from January 2021 to December 2021 were retrospectively analyzed. All the cases were underwent ligament reconstruction surgery. Cases were grouped by surgical technique:there were 14 patients in conventional reconstruction group,including 13 males and 1 female,aged from 22 to 31 years old with an average of (27.07±7.28) years old,autogenous hamstring tendon was used for ligament reconstruction. There were 15 patients in the enhanced reconstruction group,including 13 males and 2 females,aged from 25 to 34 years old with an average of (29.06±4.23) years old,double-tunnel ligament reconstruction,the autogenous hamstring muscle was used as the anteromedial bundle,and the posterolateral bundle was replaced by a high-strength line. The difference between knee tibial anterior distance,Lysholm score,International Knee Literature Committee (IKDC) subjective score,Tegner motor level score and visual analog scale (VAS) at 6th and 12th months after the surgery, limb symmetry index (LSI) were recorded at the last follow-up and surgery-related adverse effects during follow-up.
Results All patients were followed up,ranged from 13 to 15 months with an average of (13.7±0.8) months. There were no serious adverse reactions related to surgery during the period. There was no statistical difference between the preoperative general data and the observation index of the two groups (P>0.05). The difference in tibial anterior distance at 6 and 12 months in the enhanced reconstruction group (1.45±0.62) mm and (1.74±0.78) mm which were lower those that in the conventional reconstruction group (2.42±0.60) mm and (2.51±0.63) mm (P<0.05). There was no significant difference in postoperative Lysholm score,Tegner motor level score,IKDC score,VAS,and limb symmetry index at the last follow-up(P>0.05).
Conclusion The enhanced reconstruction technique can more effectively maintain the stability of the knee joint and has no significant effect on the postoperative knee joint function compared with the traditional ligament reconstruction technique. The short-term curative effect is satisfactory,and it is suitable for the group with high sports demand. |
| KEYWORDS:Knee joint Military training injury Arthroscopy Anterior cruciate ligament Rehabilitation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李宝,刘欣伟,孙扬,孙宁,王宇,段英超,崔向红,孙乙鹏,元红.前交叉韧带双束双隧道增强重建术治疗膝关节前交叉韧带损伤的临床疗效[J].中国骨伤,2024,37(7):649~654 |
| 英文格式: | LI Bao,LIU Xin-wei,SUN Yang,SUN Ning,WANG Yu,DUAN Ying-chao,CUI Xiang-hong,SUN Yi-peng,YUAN Hong.Clinical efficacy of double-bundle and double-tunnel enhanced reconstruction in the treatment of anterior cruciate ligament injury[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(7):649~654 |
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