中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
9期
914-917
,共4页
李彬%白伦浩%傅永慧%王广斌%贺明%王佳时
李彬%白倫浩%傅永慧%王廣斌%賀明%王佳時
리빈%백륜호%부영혜%왕엄빈%하명%왕가시
关节镜%前交叉韧带%膝关节%解剖重建%等长重建
關節鏡%前交扠韌帶%膝關節%解剖重建%等長重建
관절경%전교차인대%슬관절%해부중건%등장중건
Arthroscopy%Anterior cruciate ligament%Knee joint%Anatomic reconstruction%Isometry reconstruction
目的 探讨应用关节镜下标尺定位方法辅助解剖重建前交叉韧带的可行性及疗效.方法 对36例前交叉韧带损伤患者行关节镜下前交叉韧带重建术.据镜下标尺测量前交叉韧带胫骨印迹长径将患者分为双束重建组(21例)和单束重建组(15例),采用标尺测量前交叉韧带胫骨、股骨解剖印迹中心结合局部解剖标志及钟表法确定重建位置后,取自体腘绳肌腱解剖重建损伤前交叉韧带,术后随访23 ～26个月,采用IKDC评分、Lysholm评分和Tegner评分方法评价术后疗效.结果 双束重建组术后IKDC评分优良率90.4％( 19/21),术前、术后Lysholm评分分别为(62.5±6.5)、(93.8±9.9)分,Tegner 评分分别为(4.2±1.3)、(6.6±1.9)分；单束重建组术后IKDC评分优良率86.7％( 13/15),术前、术后Lysholm评分分别为(61.7±7.1)、(94.2±9.6)分,Tegner评分分别为(4.1±1.5)、(6.5±1.7)分.两组组内术前、术后各项指标比较差异均有统计学意义(Z值分别为7.82、6.33,t值分别为2.31、5.60,3.55、7.09,P均＜0.05),两组组间术前、术后各项指标比较差异均无统计学意义(Z值分别为1.35、2.04,t值分别为0.64、1.23,0.48、0.09,P均＞0.05).结论 采用关节镜下标尺测量结合其他传统方法定位解剖重建损伤前交叉韧带,简便、直观、有效,可个体化调整韧带的重建位置,值得临床推广应用.
目的 探討應用關節鏡下標呎定位方法輔助解剖重建前交扠韌帶的可行性及療效.方法 對36例前交扠韌帶損傷患者行關節鏡下前交扠韌帶重建術.據鏡下標呎測量前交扠韌帶脛骨印跡長徑將患者分為雙束重建組(21例)和單束重建組(15例),採用標呎測量前交扠韌帶脛骨、股骨解剖印跡中心結閤跼部解剖標誌及鐘錶法確定重建位置後,取自體腘繩肌腱解剖重建損傷前交扠韌帶,術後隨訪23 ～26箇月,採用IKDC評分、Lysholm評分和Tegner評分方法評價術後療效.結果 雙束重建組術後IKDC評分優良率90.4％( 19/21),術前、術後Lysholm評分分彆為(62.5±6.5)、(93.8±9.9)分,Tegner 評分分彆為(4.2±1.3)、(6.6±1.9)分；單束重建組術後IKDC評分優良率86.7％( 13/15),術前、術後Lysholm評分分彆為(61.7±7.1)、(94.2±9.6)分,Tegner評分分彆為(4.1±1.5)、(6.5±1.7)分.兩組組內術前、術後各項指標比較差異均有統計學意義(Z值分彆為7.82、6.33,t值分彆為2.31、5.60,3.55、7.09,P均＜0.05),兩組組間術前、術後各項指標比較差異均無統計學意義(Z值分彆為1.35、2.04,t值分彆為0.64、1.23,0.48、0.09,P均＞0.05).結論 採用關節鏡下標呎測量結閤其他傳統方法定位解剖重建損傷前交扠韌帶,簡便、直觀、有效,可箇體化調整韌帶的重建位置,值得臨床推廣應用.
목적 탐토응용관절경하표척정위방법보조해부중건전교차인대적가행성급료효.방법 대36례전교차인대손상환자행관절경하전교차인대중건술.거경하표척측량전교차인대경골인적장경장환자분위쌍속중건조(21례)화단속중건조(15례),채용표척측량전교차인대경골、고골해부인적중심결합국부해부표지급종표법학정중건위치후,취자체객승기건해부중건손상전교차인대,술후수방23 ～26개월,채용IKDC평분、Lysholm평분화Tegner평분방법평개술후료효.결과 쌍속중건조술후IKDC평분우량솔90.4％( 19/21),술전、술후Lysholm평분분별위(62.5±6.5)、(93.8±9.9)분,Tegner 평분분별위(4.2±1.3)、(6.6±1.9)분；단속중건조술후IKDC평분우량솔86.7％( 13/15),술전、술후Lysholm평분분별위(61.7±7.1)、(94.2±9.6)분,Tegner평분분별위(4.1±1.5)、(6.5±1.7)분.량조조내술전、술후각항지표비교차이균유통계학의의(Z치분별위7.82、6.33,t치분별위2.31、5.60,3.55、7.09,P균＜0.05),량조조간술전、술후각항지표비교차이균무통계학의의(Z치분별위1.35、2.04,t치분별위0.64、1.23,0.48、0.09,P균＞0.05).결론 채용관절경하표척측량결합기타전통방법정위해부중건손상전교차인대,간편、직관、유효,가개체화조정인대적중건위치,치득림상추엄응용.
Objective To evaluate the value of the measurement with a scale in arthroscopic anatomic anterior cruciate ligament (ACL) reconstruction.Methods Thirty-six patients with unilateral ACL-deficient knees were divided into single bundle group and double bundle group based on the length of the major axis of the native ACL footprint measured with a scale.Consistent with the International Knee Documentation Committee (IKDC) scoring systems,Lysholm knee scoring scale and Tegner activity rating were used to evaluate the clinical results,and data from 23 to 26 months follow-up were gathered and analyzed statistically.Results In terms of IKDC evaluation,19 patients( 90.4％ ) in the double band group and 13 patients( 86.7％ )in the single band group were graded as normal or nearly normal ( Z =7.82,6.33 ; P ＜ 0.05 ).The mean Lysholm scores were 93.8 ± 9.9 and 94.2 ± 9.6 and the mean Tegner scores were 6.6 ± 1.9 and 6.5 ± 1.7 for the double and single band groups,respectively( t =2.31,5.60,3.55,7.09 ;P ＜0.05 ).Conclusion Arthroscopic measurement with a scale combined with other traditional methods to determine the tunnel location is easy to conduct and intuitional to understand.It could be useful in anatomic ACL reconstruction.
