CAJ | 학술논문

目的通过与双束前交叉韧带(ACL)重建术中不保留残余组织进行比较,评估保留残余组织的作用. 方法对2003年5月至2005年6月经临床检查和关节镜检查符合标准的62例双束ACL损伤患者进行回顾性研究,根据ACL重建术中是否保留残余组织分为保残组和不保残组,每组31例,两组患者术前一般资料比较差异均无统计学意义(P＜0.05),具有可比性.记录并比较两组患者术前及术后2年主观评估[主观国际膝关节文献委员会(IKDC)评分、Lysholm评分及Cincinnati评分]和客观评估(客观IKDC评分、轴移试验及Kneelax3检查). 结果术后2年保残组的主观IKDC评分[(92.3±4.3)分]、Lysholm评分[(89.0±4.5)分]及Cincinnati评分[(91.8±4.4)分]优于不保残组[(88.2±5.2)分、(85.6±4.9)分、(87.2±6.2)分],差异均有统计学意义(P＜0.05).术后2年保残组的客观IKDC评分、轴移试验、Kneelax3检查结果与不保残组比较,差异均无统计学意义(P＞0.05).术后2年所有患者主观评估和客观评估较术前有改善,差异均有统计学意义(P＜0.05).结论与切除残余组织双束ACL重建比较,保留残余组织双束ACL重建术后膝关节主观功能恢复更好,但术后膝关节机械稳定性无明显差别.
목적 통과여쌍속전교차인대(ACL)중건술중불보류잔여조직진행비교,평고보류잔여조직적작용. 방법 대2003년5월지2005년6월경림상검사화관절경검사부합표준적62례쌍속ACL손상환자진행회고성연구,근거ACL중건술중시부보류잔여조직분위보잔조화불보잔조,매조31례,량조환자술전일반자료비교차이균무통계학의의(P＜0.05),구유가비성.기록병비교량조환자술전급술후2년주관평고[주관국제슬관절문헌위원회(IKDC)평분、Lysholm평분급Cincinnati평분]화객관평고(객관IKDC평분、축이시험급Kneelax3검사). 결과 술후2년보잔조적주관IKDC평분[(92.3±4.3)분]、Lysholm평분[(89.0±4.5)분]급Cincinnati평분[(91.8±4.4)분]우우불보잔조[(88.2±5.2)분、(85.6±4.9)분、(87.2±6.2)분],차이균유통계학의의(P＜0.05).술후2년보잔조적객관IKDC평분、축이시험、Kneelax3검사결과여불보잔조비교,차이균무통계학의의(P＞0.05).술후2년소유환자주관평고화객관평고교술전유개선,차이균유통계학의의(P＜0.05).결론 여절제잔여조직쌍속ACL중건비교,보류잔여조직쌍속ACL중건술후슬관절주관공능회복경호,단술후슬관절궤계은정성무명현차별.
Objective To compare the remnant preservation (RP) and the remnant resection (RR) techniques in double-bundle anterior cruciate ligament (ACL) reconstruction using hamstring tendon grafts.Methods Included in this study were 62 patients with injury to the ACL double bundles who met our criteria and had been treated from May 2003 to June 2005 in our department.They were divided into an RP group (n =31) and a RR(n =31) group.There was no significant difference between the 2 groups regarding general clinical data (P ＜ 0.05).The subjective evaluations of the patients [subjective International Knee Documentation Committee(IKDC) score,Lysholm score and Cincinnati knee score] and objective ones (objective IKDC score,pivot shift test and Kneelax3 measurement) were recorded preoperatively and postoperatively and compared between the 2 groups.Results At 2 years postoperation,the average subjective IKDC score (92.3 ± 4.3 points),Lysholm score (89.0±4.5 points) and Cincinnati knee score (91.8 ±4.4 points) for the RP group were significantly better respectively than those for the RR group (88.2 ± 5.2,85.6 ± 4.9,87.2 ± 6.2points) (P ＜ 0.05).There were,however,no significant differences at 2 years postoperation between the 2 groups regarding the average objective IKDC score,pivot shift test or Kneelax3 measurement (P ＞ 0.05).The results of all the subjective and objective evaluations improved significantly at 2 years postoperation compared with preoperation in all patients (P ＜ 0.05).Conclusion Compared with the RR technique,RP technique may have a significant advantage in the subjective clinical outcomes in the double-bundle ACL reconstruction using hamstring tendon grafts,but shows no significant difference in the postoperative mechanical stability of the knee.