CAJ | 학술논문

目的评估关节镜下保留残端的后交叉韧带(PCL)重建的技术和效果.方法 2006年1月至2009年1月,16例(16膝)患者经关节镜检查证实为PCL断裂.关节镜下对原PCL残端不做切除,采用自体四股腘绳肌腱两切口法,单柬重建PCL,采用悬吊钢板和生物可吸收挤压螺钉解剖复位固定重建韧带.结果本组术后早期均未发生严重并发症.术后随访4～14个月,平均(7.4±2.1)个月,Lysholm膝关节功能评分由术前平均(61.3±8.7)分,提高至随访时的(91.7±6.3)分(P＜0.05).国际膝关节文件编制委员会(IKDC)综合评定由术前异常(C级)9膝、显著异常(D级)7膝,改进为随访时正常(A级)11膝、接近正常(B级)5膝.16例患者均恢复至伤前运动水平.结论关节镜下保留残端的PCL重建术对关节内干扰小,可能有利于重建韧带血供和神经支配的重新获得,手术操作简捷,术后膝关节功能恢复满意.
목적 평고관절경하보류잔단적후교차인대(PCL)중건적기술화효과.방법 2006년1월지2009년1월,16례(16슬)환자경관절경검사증실위PCL단렬.관절경하대원PCL잔단불주절제,채용자체사고객승기건량절구법,단간중건PCL,채용현조강판화생물가흡수제압라정해부복위고정중건인대.결과 본조술후조기균미발생엄중병발증.술후수방4～14개월,평균(7.4±2.1)개월,Lysholm슬관절공능평분유술전평균(61.3±8.7)분,제고지수방시적(91.7±6.3)분(P＜0.05).국제슬관절문건편제위원회(IKDC)종합평정유술전이상(C급)9슬、현저이상(D급)7슬,개진위수방시정상(A급)11슬、접근정상(B급)5슬.16례환자균회복지상전운동수평.결론 관절경하보류잔단적PCL중건술대관절내간우소,가능유리우중건인대혈공화신경지배적중신획득,수술조작간첩,술후슬관절공능회복만의.
Objective To evaluate the technique and outcome of arthroscopic reconstruction of posterior cruciate ligament(PCL)with preservation of the remnants.Methods From January 2006 to January 2009.16 knees in 16 patients with PCL tear were verified with arthroscopy.All the damaged PCL were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy without remove of the remnants of PCL.Endo-button and Bio-absorbabh interference screw were used for direct anatomic fixation of the reconstructed ligament.Results No severe complication occurred in early stage after operation in the 16 patients.All of them were followed up from 4 to 14 months with an average of (7.4±2.1)months.Lysholm score was remarkable improved from mean(61.3±8.7)preoperative scores to mean(91.7±6.3)scores at the latest follow up(P＜0.05).Furthermore,there was a significant improvement in IKDC scofe from abnormal (grade C)in 9 knees and severely abnormal (grade D)in 7 knees preoperatively to normal(grade A)in 11 knees,nearly normal(grade B)in 5 knees at the follow up.All of the 16 patients returned to the same sports level before injury.Conclusion Arthroscopic reconstruction of PCL with preservadon of the remnants has advantages of minimal inmmrticular interference,and potential facility to revagculization and reinnervation of the reconstlucted ligament.