保残与非保残重建后交叉韧带的病例对照研究  

Case-control studies on clinical effects of non-and remnant preservation for reconstruction of posterior cruciate ligament

作　　者：王军[1] 姜鑫[1] 张益民[1] 郭永智[1] 

机构地区：[1]潍坊市人民医院关节外科,山东潍坊261041

出　　处：《中国骨伤》2013年第5期365-369,共5页China Journal of Orthopaedics and Traumatology

摘　　要：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。Objective ：To evaluate the methods and therapeutic effects of the posterior cruciate ligament （PCL） recon- struction 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 op- eration, 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 fixa- tion 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.

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 

分 类 号：R687.2[医药卫生—骨科学]