导航辅助前十字韧带单束与双束重建的比较研究

 目的 比较导航辅助前十字韧带单束与双束重建的临床效果。方法 对导航辅助的前十字韧带单束与双束重建病例进行回顾性队列研究, 单束重建组29 例、双束重建组28 例, 分别使用导航辅助单束、双束重建技术。两组术前KT-1000 患侧与健侧膝关节前向稳定性差值、轴移试验、国际膝关节评分委员会(International Knee Documentation Committee, IKDC)膝关节功能评级的差异均无统计学意义。结果 两组病例随访时间均超过2 年。末次随访时单束重建组膝关节前向稳定性差值为(1.6±5.1)mm, 双束重建组为(2.2±3.0)mm, 差异无统计学意义。单束重建组轴移试验阳性率为14.3%, 双束重建组为29.6%, 差异无统计学意义。单束重建组IKDC 膝关节功能评级优于双束重建组, 差异有统计学意义。单束重建组10 例行二次关节镜检查, 均可见移植物连续且张力好;双束重建组28 例行二次关节镜检查, 8 例(28.6%, 8/28)可见后外束且张力较好, 15 例(53.6%, 15/28)可见后外束但松弛, 5 例(17.8%, 5/28)未见后外束。结论 导航辅助前十字韧带单束与双束重建术后早期膝关节稳定性相同, 单束重建患者对术后膝关节功能的主观评分优于双束重建患者。

Comparison between navigation-assisted single-bundle and double-bundle technique in anterior cruciate ligament reconstruction

Objective To compare the clinical Results of navigation-assisted single-bundle and double-bundle technique in anterior cruciate ligament (ACL) reconstruction. Methods A retrospective cohort study was designed and 57 patients with ACL injury in one knee were recruited for navigation-assisted ACL reconstruction. Twenty-nine patients were assigned to single-bundle reconstruction group and 28 to doublebundle reconstruction group. Preoperatively, there is no significant difference in International Knee Documentation Committee (IKDC) knee scores, KT-1000 and pivot-shift test Results between two groups. Results The average follow-up periods were 47.1 months for single-bundle group and 36.2 months for double-bundle group. Stability result of the KT-1000 measurement was improved from (7.7±2.1) mm preoperatively to (1.6±5.1) mm at the last follow-up for single-bundle group, and from (7.9±3.7) mm to (2.2±3.0) mm for doublebundle group. KT-1000 measurements and pivot-shift tests at final follow-up failed to reveal any significant intergroup differences (P>0.05). The IKDC grades in the single-bundle group were significantly better than those in double-bundle group (P<0.05) at final follow-up. Second-look arthroscopies were performed in 10 patients in single-bundle group and 28 patients in double-bundle group. For 10 patients in single-bundle group, the arthroscopy showed the implants were continued with good tension. For double-bundle group, the arthroscopic findings revealed that posterolateral (PL) bundle was visible with good tension in 28.6% of patients, PL bundle was visible but loose in 53.6% and PL bundle was invisible in the other 17.8% patients. Conclusion The navigation-assisted single-bundle and double-bundle ACL reconstruction produces are similar in terms of postoperative stability of knee. However, compared with double-bundle technique, the single-bundle technique can obtain better IKDC grades.