CAJ | 학술논문

目的探讨在LARS韧带重建前交叉韧带(ACL)手术中,关节镜下运用X线透视定位法的操作特点和临床疗效.方法 2006年6月起运用法国LARS韧带治疗急性膝关节ACL断裂36例,男25例,女11例;年龄22～51岁,平均28.3岁.左膝19例,右膝17例.所有患者术前MRI均提示ACL连续信号中断,膝关节Lysholm评分平均52分.操作在关节镜下完成,其中股骨隧道口定位、胫骨隧道口定位主要依靠术中C形臂X线机定位;LARS韧带直径为7.5 mm,空心挤压螺钉直径为8.0 mm.结果本组患者获9～20个月(平均18个月)随访.36例患者术前Lysholm评分平均为52分;术后12个月平均为92分.本组优23例,良9例,可4例,近期优良率为89%.结论在关节镜下运用X线透视定位法进行LARS人工韧带重建膝ACL,操作方便,定位准确,手术效果优良.
목적 탐토재LARS인대중건전교차인대(ACL)수술중,관절경하운용X선투시정위법적조작특점화림상료효.방법 2006년6월기운용법국LARS인대치료급성슬관절ACL단렬36례,남25례,녀11례;년령22～51세,평균28.3세.좌슬19례,우슬17례.소유환자술전MRI균제시ACL련속신호중단,슬관절Lysholm평분평균52분.조작재관절경하완성,기중고골수도구정위、경골수도구정위주요의고술중C형비X선궤정위;LARS인대직경위7.5 mm,공심제압라정직경위8.0 mm.결과 본조환자획9～20개월(평균18개월)수방.36례환자술전Lysholm평분평균위52분;술후12개월평균위92분.본조우23례,량9례,가4례,근기우량솔위89%.결론 재관절경하운용X선투시정위법진행LARS인공인대중건슬ACL,조작방편,정위준학,수술효과우량.
Objective To discuss the operation skills and clinical effects of C-arm fluoroscopy in arthroscopic reconstruction of anterior cruciate ligament(ACL)with the Ligament Advancement Reinforcement System(LARS)artificial ligaments.Methods The study involved 36 patients with acute ACL rupture treated with the LARS artificial ligaments from June 2006.There were 25 males and 11 females,at age range of 22-51 years(average 28.3 years),involving 19 left knees and 17 right knees.The results of preoperative MRI of all patients suggested discontinuation of ACL,with average score of Lysholm on knee joint for 50.The operation was completed under arthroscope.While the locations of the femoral tunnel portal and the tibial tunnel exit were mainly determined by the C-arm fluoroscopy.The diameter of the LARS artificial ligament was 7.5 mm while that of the interference screw 8 mm.Results All 36 patients were followed up for a mean duration of 18 months(9-20 months).The average Lysholm Score was 52 preoperatively and 92 at the 12th week after operation.The clinical results were graded as excellent in 23 patients,good in nine and fair in four according to the Lysholm's classification,with excellence rate of 89%.Conclusions Arthroscopic reconstruction of anterior cruciate ligament with LARS artifical ligament under C-arm fluoroscopy takes advantages of convenient operation,accurate location and satisfactory clinical effect.