中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
11期
16-19
,共4页
任广军%谢幼专%苏晋%孙磊
任廣軍%謝幼專%囌晉%孫磊
임엄군%사유전%소진%손뢰
前交叉韧带%腘绳肌腱%髁间窝成形术
前交扠韌帶%腘繩肌腱%髁間窩成形術
전교차인대%객승기건%과간와성형술
Anterior cruciate ligament%Hamstring tendon%Intercondylar notch plasty
目的 探讨陈旧性前交叉韧带(ACL)损伤采用四股腘绳肌腱重建的临床疗效及髁间窝成形术的应用价值.方法 关节镜下采用四股半腱肌腱及股薄肌腱重建治疗56例陈旧性ACL损伤患者,其中45例应用髁间窝成形术.56例患者术前Lachman试验(+),MRI证实ACL损伤,按照Lysholm膝关节评分及KT-1000关节测量仪测定结果评价疗效.结果 56例患者均获得随访,随访时间6~24( 13.024.2)个月,术后Lachman试验(-)53例,(±)3例.Lysholm膝关节评分由术前的(56.0±7.3)分增加至术后随访时的(93.0±3.5)分,差异有统计学意义(t=34.20,P< 0.01).术后KT-1000关节测量仪测定患者双侧膝关节前向松弛度差值<3.0 mm、平均移动度(2.0±0.6) mm,与术前双侧膝关节前向松弛度差值≥3.0 mm、平均移动度(3.0±1.2) mm比较差异有统计学意义(t=5.58,P< 0.05).结论 关节镜下四股腘绳肌腱重建ACL,疗效确切,术后患者可早期康复锻炼.术中应用髁间窝成形术,可减少术后撞击综合征,且骨隧道定位准确,提高了手术疗效.
目的 探討陳舊性前交扠韌帶(ACL)損傷採用四股腘繩肌腱重建的臨床療效及髁間窩成形術的應用價值.方法 關節鏡下採用四股半腱肌腱及股薄肌腱重建治療56例陳舊性ACL損傷患者,其中45例應用髁間窩成形術.56例患者術前Lachman試驗(+),MRI證實ACL損傷,按照Lysholm膝關節評分及KT-1000關節測量儀測定結果評價療效.結果 56例患者均穫得隨訪,隨訪時間6~24( 13.024.2)箇月,術後Lachman試驗(-)53例,(±)3例.Lysholm膝關節評分由術前的(56.0±7.3)分增加至術後隨訪時的(93.0±3.5)分,差異有統計學意義(t=34.20,P< 0.01).術後KT-1000關節測量儀測定患者雙側膝關節前嚮鬆弛度差值<3.0 mm、平均移動度(2.0±0.6) mm,與術前雙側膝關節前嚮鬆弛度差值≥3.0 mm、平均移動度(3.0±1.2) mm比較差異有統計學意義(t=5.58,P< 0.05).結論 關節鏡下四股腘繩肌腱重建ACL,療效確切,術後患者可早期康複鍛煉.術中應用髁間窩成形術,可減少術後撞擊綜閤徵,且骨隧道定位準確,提高瞭手術療效.
목적 탐토진구성전교차인대(ACL)손상채용사고객승기건중건적림상료효급과간와성형술적응용개치.방법 관절경하채용사고반건기건급고박기건중건치료56례진구성ACL손상환자,기중45례응용과간와성형술.56례환자술전Lachman시험(+),MRI증실ACL손상,안조Lysholm슬관절평분급KT-1000관절측량의측정결과평개료효.결과 56례환자균획득수방,수방시간6~24( 13.024.2)개월,술후Lachman시험(-)53례,(±)3례.Lysholm슬관절평분유술전적(56.0±7.3)분증가지술후수방시적(93.0±3.5)분,차이유통계학의의(t=34.20,P< 0.01).술후KT-1000관절측량의측정환자쌍측슬관절전향송이도차치<3.0 mm、평균이동도(2.0±0.6) mm,여술전쌍측슬관절전향송이도차치≥3.0 mm、평균이동도(3.0±1.2) mm비교차이유통계학의의(t=5.58,P< 0.05).결론 관절경하사고객승기건중건ACL,료효학절,술후환자가조기강복단련.술중응용과간와성형술,가감소술후당격종합정,차골수도정위준학,제고료수술료효.
Objective To investigate clinical efficacy of reconstructing for old anterior cruciate ligament(ACL) injury with quadruple hamstring tendon,and application value of femoral intercondylar notch plasty.Methods Fifty-six cases of old ACL injury were reconstructed arthroscopically with quadruple hamstring tendon.Forty-five cases were used femoral intercondylar notch plasty.Preoperative Lachman test were positive,and ACL injury were confirmed by MRI.The curative effect was evaluated according to Lysholm knee score and KT-1000 measurement results.Results All of the 56 patients were followed up for 6-24 (13.0 ± 4.2) months.Postoperative Lachman test of 53 cases were negative,and 3 cases were weak positive.The Lysholm knee score increased from preoperative (56.0 ± 7.3) scores to postoperative (93.0 ± 3.5 ) scores,comparison of preoperative had significant difference (t =34.20,P < 0.01 ).The postoperative KT-1000 measurement showed < 3.0 mm side difference of anterior laxity,moving average of (2.0 ± 0.6) mm,comparison of preoperative ≥ 3.0 mm,moving average of (3.0 ± 1.2 ) mm had significant difference (t =5.58,P < 0.01 ).Conclusions Arthroscopic reconstruction of ACL with quadruple hamstring tendon have a good effect.The postoperative rehabilitation exercise can practise early.The femoral intercondylar notch plasty which used during operation is benefit of decreasing femoral intercondylar notch impingement syndrome,accurate positioning femur tunnel,and increasing curative effect.