上海医学
上海醫學
상해의학
SHANGHAI MEDICAL JOURNAL
2010年
3期
260-264,封3
,共6页
袁拥军%何国础%岑建平%张振庆%孙长惠
袁擁軍%何國礎%岑建平%張振慶%孫長惠
원옹군%하국출%잠건평%장진경%손장혜
韧带增强重建系统人工韧带%后交叉韧带%重建
韌帶增彊重建繫統人工韌帶%後交扠韌帶%重建
인대증강중건계통인공인대%후교차인대%중건
Ligament advanced reinforcement system artificial ligament%Posterior cruciate ligament%Reconstruction
目的 探讨关节镜下应用先进人工韧带加强系统(LARS)人工韧带重建膝关节后交叉韧带(PCL)的可行性及近期疗效.方法 选择PCL损伤的患者15例,后抽屉试验为Ⅱ～Ⅲ度,均存在后方不稳定的症状和体征,但无后外角等严重复合损伤.应用法国LARS人工韧带于关节镜下行单束重建膝关节PCL术.比较术前与术后随访3、6及12个月的Lysholm、Tegner评分.结果 术后无1例发生严重的并发症,无滑膜炎产生,无韧带断裂和松动.术后3、6及12个月的Lysholm评分分别为(73.87±3.16)、(90.14±1.99)及(90.86±1.17)分,均显著高于术前的(48.8±5.11)分(P值均<0.01),术后6个月与12个月的Lysholm评分的差异无统计学意义(P0.05).术后3、6及12个月的Tegner评分分别为(5.60±0.51)、(7.53±0.52)及(7.73±0.46)分,均显著高于术前的(1.93±0.96)分(P值均<0.01),术后6个月与术后12个月的Tegner评分的差异无统计学意义(P0.05).根据国际膝关节评分委员会的评分标准分级为A 12例,B 3例.结论 对于单纯性膝关节PCL断裂并有手术指征的患者,采用关节镜下LARS人工韧带重建PCL的创伤小,可取得较好的疗效.
目的 探討關節鏡下應用先進人工韌帶加彊繫統(LARS)人工韌帶重建膝關節後交扠韌帶(PCL)的可行性及近期療效.方法 選擇PCL損傷的患者15例,後抽屜試驗為Ⅱ～Ⅲ度,均存在後方不穩定的癥狀和體徵,但無後外角等嚴重複閤損傷.應用法國LARS人工韌帶于關節鏡下行單束重建膝關節PCL術.比較術前與術後隨訪3、6及12箇月的Lysholm、Tegner評分.結果 術後無1例髮生嚴重的併髮癥,無滑膜炎產生,無韌帶斷裂和鬆動.術後3、6及12箇月的Lysholm評分分彆為(73.87±3.16)、(90.14±1.99)及(90.86±1.17)分,均顯著高于術前的(48.8±5.11)分(P值均<0.01),術後6箇月與12箇月的Lysholm評分的差異無統計學意義(P0.05).術後3、6及12箇月的Tegner評分分彆為(5.60±0.51)、(7.53±0.52)及(7.73±0.46)分,均顯著高于術前的(1.93±0.96)分(P值均<0.01),術後6箇月與術後12箇月的Tegner評分的差異無統計學意義(P0.05).根據國際膝關節評分委員會的評分標準分級為A 12例,B 3例.結論 對于單純性膝關節PCL斷裂併有手術指徵的患者,採用關節鏡下LARS人工韌帶重建PCL的創傷小,可取得較好的療效.
목적 탐토관절경하응용선진인공인대가강계통(LARS)인공인대중건슬관절후교차인대(PCL)적가행성급근기료효.방법 선택PCL손상적환자15례,후추체시험위Ⅱ～Ⅲ도,균존재후방불은정적증상화체정,단무후외각등엄중복합손상.응용법국LARS인공인대우관절경하행단속중건슬관절PCL술.비교술전여술후수방3、6급12개월적Lysholm、Tegner평분.결과 술후무1례발생엄중적병발증,무활막염산생,무인대단렬화송동.술후3、6급12개월적Lysholm평분분별위(73.87±3.16)、(90.14±1.99)급(90.86±1.17)분,균현저고우술전적(48.8±5.11)분(P치균<0.01),술후6개월여12개월적Lysholm평분적차이무통계학의의(P0.05).술후3、6급12개월적Tegner평분분별위(5.60±0.51)、(7.53±0.52)급(7.73±0.46)분,균현저고우술전적(1.93±0.96)분(P치균<0.01),술후6개월여술후12개월적Tegner평분적차이무통계학의의(P0.05).근거국제슬관절평분위원회적평분표준분급위A 12례,B 3례.결론 대우단순성슬관절PCL단렬병유수술지정적환자,채용관절경하LARS인공인대중건PCL적창상소,가취득교호적료효.
Objective To study the feasibility and short-term effects of arthroscopic posterior cruciate ligament (PCL) reconstruction using the ligament Advancement Reinforcement System (LARS). Methods This retrospective analysis included 15 patients (male/female; 2/13), with a mean age of 25.3 years. All patients were diagnosed as having isolated posterior ligament tears, with an average posterior laxity of Ⅱ-Ⅲ degrees according to post drawer test preoperatively. The procedures were performed averagely 56 days after the accident. Arthroscopic reconstruction was performed in all patients. Posterior cruciate ligament repair was achieved with the adjunction of a polyester ligament (LARS) using one strand technique. Patients were followed up for 3, 6, and 12 months after operation, and the Lysholm and Tegner scores were compared with those before operation. Results There were no complications (synovitis, spontaneous tear) directly related to the synthetic ligament after operation. The Lysholm scores at 3, 6, and 12 months after operation were(73.87 ± 3. 16), (90.14±1.99), and (90.86±1. 17), respectively, which were significantly higher than that before operation (48.8±5.11, P<0. 001), but the scores were not significantly different at 6 and 12 months after operation. The Tegner scores at 3, 6, and 12 months after operation were(5.60 ± 0.51), (7.53 ± 0.52), and (7.73 ± 0.46),respectively, which were significantly higher than that before operation(1.93 ± 0.96, P<0. 001), but the Tegner scores were not significantly different at 6 and 12 months after operation. The overall IKDC score was A in 12 cases and B in 3 cases. Conclusion LARS artificial ligaments can rapidly promote the recovery and has satisfactory outcome for patients with simple knee joint PCL rupture. The procedure is minimal invasive, easier to manipulate under arthroscopy. The technique spares tendon stock and can be proposed for major posterior cruciate ligament laxity.
