关节镜下解剖位与过顶位前交叉韧带单束重建的近期疗效对比  

Anatomic versus conventional over-the-top single-bundle in arthroscopic reconstruction of anterior cruciate ligament

作　　者：李文凯[1] 吴华[1] 韦盛[1] 王威[1] 游洪波[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院骨科,武汉430030

出　　处：《骨科》2015年第3期113-116,共4页ORTHOPAEDICS

摘　　要：目的比较关节镜下前交叉韧带(anterior cruciate ligament,ACL)解剖位单束(anatomic single-bundle,ASB)与传统过顶位单束(conventional over-the-top single-bundle,CSB)重建的近期临床疗效。方法回顾分析2010年10月至2012年10月在我院关节外科接受ACL重建手术的病例及随访资料,按手术方式不同分为ASB组(n=31)和CSB组(n=32),移植韧带来源均为自体腘绳肌腱。比较两组患者在术后3~6个月的膝关节功能,评估方法采用膝关节主动活动度、Lachman试验、轴移试验、Lysholm评分及国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分。结果术后膝关节主动活动度:CSB组3例术后膝关节伸直受限,平均5°~10°,ASB组无伸直受限,两组屈曲均正常;Lachman试验:ASB组全部阴性,CSB组6例阳性,差异有统计学意义(P<0.05);轴移试验:ASB组阴性率为67.74%,CSB组阴性率为40.63%,差异有统计学意义(P<0.05);Lysholm评分及IKDC评分差异均无统计学意义(均P>0.05)。结论 ACL的ASB重建术后早期能更好地恢复膝关节的前后及旋转稳定性,其临床意义及远期临床效果有待进一步研究。Objective To compare the recent clinical results of the arthroscopic single-bundle ACL reconstruction with conventional over-the-top and anatomic insertions. Methods The curative results and follow-up data were retrospective analyzed in cases with ACL injure which were treated with ACL reconstruction in our hospital from Oct. 2010 to Oct. 2012. All cases were performed single-bundle reconstruction with autogeneic hamstring tendons and divided into 2 groups（CSB group and ASB group） according to surgical opinions. The knee functions after 3 to 6 months of operation were evaluated by active joint flexion degree, pivot shift test, Lachman test, IKDC and Lysholm scores. Results The active joint flexion degree： 3 cases presented 5^-10~ extension limitation in CSB with no flexion limitatiom no flexion limitation and extension limitation in ASB cases. Lachman test： all cases presented negative Lachman test in ASB while 6 positive in CSB. Negative pivot shift was 67. 74% in ASB vs. 40. 63% in CSB. There＇s no significance different between 2 groups on Lysholm and IKDC scores（all P〉0. 05）. Conclusion ASB reconstruction resulted in better anteroposterior and rotational stability than CSB reconstruction. However, further follow-up clinical study are needed.

关 键 词：关节镜检查 前交叉韧带重建 膝关节 修复外科手术 

分 类 号：R687.4[医药卫生—骨科学]