膝后交叉韧带损伤的诊治及康复策略  

Posterior cruciate ligament injury:diagnosis,treatments and rehabilitation strategies

作　　者：徐宝鋆 付维力[1] Xu Baoyun;Fu Weili(Department of Orthopedics,West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西医院骨科,四川省成都市610041

出　　处：《中国组织工程研究》2021年第11期1766-1772,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:随着后交叉韧带损伤的增多,目前对于后交叉韧带损伤的诊治方案层出不穷,以及对于后交叉韧带损伤完整性的综述较少。目的:从后交叉韧带的解剖开始,对后交叉韧带损伤的临床表现、辅助检查、治疗方式、康复策略进行了完整的综述。方法:作者经PubMed、Ovid、万方、知网等检索平台检索了相关文献,检索关键词为"Posterior cruciate ligament, PCL, anatom*, diagnos*,treatments,surger*,rehabilitation,后交叉韧带,解剖,诊断,治疗,康复"。共检索223篇文献,筛除重复以及阅读摘要及全文后不符合纳排标准的文献,最终纳入文献65篇进行综述。结果与结论:后交叉韧带的损伤存在一定的漏诊性和误诊性。后交叉韧带损伤多为交通伤和运动伤所致,并一定概率上伴随着其他结构的损伤,对患者病史的熟悉、准确的体格检查方式、精密的辅助检查有助正确的识别后交叉韧带及其周围结构的损伤,以制定合理的诊疗方案。研究提示,后交叉韧带损伤患者应尽早进行重建,以降低进一步退变的风险。目前在后交叉韧带损伤的诊断、治疗方式及康复策略上仍有较大的异议,亟需大宗、严谨的随机对照试验来挑选出最为合适的诊断治疗方式。BACKGROUND:With the increasing cases of posterior cruciate ligament injury,there are endless protocols for diagnosing and treating posterior cruciate ligament injury.However,there are few reviews of the integrity of posterior cruciate ligament.OBJECTIVE:To complete a comprehensive review of posterior cruciate ligament injury in terms of anatomy,clinical manifestations,auxiliary examination,treatment methods and rehabilitation strategies.METHODS:The PubMed,Ovid,CKNI,and WanFang databases were retrieved using the key words of“posterior cruciate ligament,PCL,anatom*,diagnos*,treatments,surger*,rehabilitation.”A total of 223 articles were searched.After removal of repetitive and ineligible literature,65 articles were included for review.RESULTS AND CONCLUSION:Missed diagnosis and misdiagnosis of posterior cruciate ligament injury certainly exist.Posterior cruciate ligament injuries are mostly caused by traffic injuries and sports injuries,and are accompanied by other structural injuries to a certain degree.A full understanding of patient’s medical history,accurate physical examination methods,and sophisticated auxiliary examinations can help to correctly identify injuries to the posterior cruciate ligament and the surrounding structures,so as to formulate a reasonable diagnosis and treatment protocol.Research suggests that patients with posterior cruciate ligament injury should be subjected to reconstruction of the posterior cruciate ligament as soon as possible to reduce the risk of further degeneration.At present,there are still large disagreements on the diagnosis,treatment methods,and rehabilitation strategies of posterior cruciate ligament injury.So,a large number of rigorous randomized controlled trials are urgently needed to select the most suitable diagnosis and treatment methods.

关 键 词：膝 关节 韧带 后交叉韧带损伤 解剖 韧带重建 综述 

分 类 号：R459.9[医药卫生—治疗学] R496[医药卫生—临床医学]