| 关节镜下全内技术股骨双隧道重建膝关节前交叉韧带 |
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| 引用本文： | 李文俊,孙健,刘葛君. 关节镜下全内技术股骨双隧道重建膝关节前交叉韧带[J]. 中华关节外科杂志(电子版), 2018, 12(6): 768-772. DOI: 10.3877/cma.j.issn.1674-134X.2018.06.005 |
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| 作者姓名： | 李文俊 孙健 刘葛君 |
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| 作者单位： | 1. 200072 上海同济大学附属第十人民医院骨科 |
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| 摘 要： | 目的总结关节镜下利用全内技术股骨双隧道重建膝关节前交叉韧带的临床疗效。 方法收集于2015年12月至2016年8月期间在上海同济大学附属第十人民医院骨科住院治疗的膝关节前交叉韧带断裂病例，根据纳入、排除标准，共有16例(16膝)纳入本研究，男性11例(68.8%)，女性5例(31.3%)，平均年龄(30 ± 6)岁。回顾性分析手术前及末次随访时国际膝关节文献委员会(IKDC)膝关节评分及分级、Lysholm评分、KT2000值、Lachman试验情况、轴移试验情况。采用SPSS 13.0统计学软件对IKDC评分、Lysholm评分、KT2000值行配对样本t检验，Lachman试验情况、轴移试验情况等计数资料行秩和检验或卡方检验。 结果16例患者随访时间14～32个月，平均25.5个月(22.3，29.6)个月。随访期内未出现移植物断裂、TightRope?钢板固定失效、血栓性静脉炎、关节感染、隐神经损伤。IKDC评分、Lysholm评分分别由术前的(67±4)分、(63±6)分提高至末次随访时(95±5)分、(95±4)分，差异具有统计学意义(t＝－19.40、16.04，均为P<0.01)。IKDC分级术前A级0例，B级1例，C级1例，D级14例；术后A级13例、B级3例、C级0例、D级0例(Z＝－5.18，P<0.05)，差异具有统计学意义。KT2000值术前平均(5.8±1.3)mm，优于术后测得平均(1.2±0.6)mm，差异有统计学意义(t＝12.24，P<0.01)；Lachman试验术前阳性15例、阴性1例，术后阳性0例、阴性16例；轴移试验术前阳性13例、阴性3例，术后阳性0例、阴性16例。 结论利用全内技术行关节镜下股骨双隧道膝关节前交叉韧带重建，患者膝关节功能、前直向不稳定、前外侧旋转不稳定的近期疗效满意。
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| 关 键 词： | 关节镜检查 前交叉韧带 移植，异位 |
Clinical study of anterior cruciate ligament reconstruction using double-femoral-tunnel method with all-inside techniques |
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| Wenjun Li,Jian Sun,Gejun Liu. Clinical study of anterior cruciate ligament reconstruction using double-femoral-tunnel method with all-inside techniques[J]. Chinese Journal of Joint Surgery(Electronic Version), 2018, 12(6): 768-772. DOI: 10.3877/cma.j.issn.1674-134X.2018.06.005 |
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| Authors: | Wenjun Li Jian Sun Gejun Liu |
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| Affiliation: | 1. Department of Orthopedics, Tenth People’s Hospital of Tongji University, Shanghai 200072, China |
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| Abstract: | ObjectiveTo summarize the clinical effects of anterior cruciate ligament reconstruction using double-femoral-tunnel method with all-inside and TightRope? techniques. MethodsRetrospective analysis of patients with anterior cruciate ligament ruptures who were hospitalized in the Department of Orthopedics, Tenth People's Hospital of Tongji University from December 2015 to August 2016. According to the inclusion and exclusion criteria, a total of 16 patients (16 knees) were included in the study, 11 males (68.8%), five females (31.3%), and an average age of (30 ± 6) years. Paired sample t-test was performed on IKDC score, Lysholm score and KT2000 value using SPSS13.0 statistical software. Rank data was tested by rank sum test or chi-square test. ResultsSixteen patients were followed up for 14~32 months with median time of 25.5 months(22.3, 9.6) months. There were no graft re-rupture, TightRope? plate fixation failure, thrombophlebitis, joint infection, and saphenous nerve injury during the follow-up period.The IKDC score and Lysholm score were increased from (67±4)points and (63±6) to the last follow-up (95±5) points and (95±4) points, respectively. The difference was statistically significant (t=-19.40, 16.04; both P<0.01). Preoperative IKDC classification: none of grade A, one case of grade B, one case of grade C, 14 cases of grade D; postoperative: 13 cases of grade A, three of grade B, none of grade C or grade D; (Z=-5.18, P<0.05), and the difference was statistically significant. The KT2000 value was(1.2±0.6) mm after the operation, which was better than the average (5.8±1.3) mm before operation. The difference was statistically significant (t=12.24, P<0.01). Preoperative Lachman test: 15 cases were positive, one case was negative, postoperative: 16 cases were negative; preoperative pivot shift test: 13 cases were positive, three cases were negative, postoperative: 16 cases were negative. ConclusionArthroscopic anterior cruciate ligament reconstruction using all-inside & TightRope? techniques of the femoral double tunnel has satisfactory short-term results of knee joint function, anterior straight instability, and anterior lateral rotation instability. |
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| Keywords: | Arthroscopy Anterior cruciate ligament reconstruction Transplantation heterotopic |
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