CAJ | 학술논문

目的探讨应用自体腘绳肌腱关节镜下加强重建前交叉韧带(ACL)部分损伤的手术疗效. 方法对2008年1月至2010年3月收治的28例(28膝)ACL部分损伤患者进行回顾性研究,男22例,女6例；年龄21 ～51岁,平均31.2岁.所有患者在关节镜下根据韧带损伤部分的残端足印区位置做直径为6～7 mm的股骨隧道和胫骨隧道,取自体半腱肌腱或股薄肌腱进行加强重建. 结果所有患者术后获27 ～ 54个月(平均33.6个月)随访.术后所有患者Lachman试验均转为阴性,24例为硬性终末点.术后25例患者轴移试验保持阴性,有3例患者出现轴移1+,术中关节镜检查均为损伤纤维超过50％者.KT-1000测量由术前平均为(2.1±0.4)mm改善为术后(0.6±0.3)mm,差异有统计学意义(t=16.141,P=0.000).Lysholm评分由术前(72.8±8.6)分提高至术后(97.1±2.2)分,差异有统计学意义(t=13.793,P=0.000). 结论关节镜下自体腘绳肌腱加强重建ACL,有利于恢复膝关节的稳定性.
목적 탐토응용자체객승기건관절경하가강중건전교차인대(ACL)부분손상적수술료효. 방법 대2008년1월지2010년3월수치적28례(28슬)ACL부분손상환자진행회고성연구,남22례,녀6례；년령21 ～51세,평균31.2세.소유환자재관절경하근거인대손상부분적잔단족인구위치주직경위6～7 mm적고골수도화경골수도,취자체반건기건혹고박기건진행가강중건. 결과 소유환자술후획27 ～ 54개월(평균33.6개월)수방.술후소유환자Lachman시험균전위음성,24례위경성종말점.술후25례환자축이시험보지음성,유3례환자출현축이1+,술중관절경검사균위손상섬유초과50％자.KT-1000측량유술전평균위(2.1±0.4)mm개선위술후(0.6±0.3)mm,차이유통계학의의(t=16.141,P=0.000).Lysholm평분유술전(72.8±8.6)분제고지술후(97.1±2.2)분,차이유통계학의의(t=13.793,P=0.000). 결론 관절경하자체객승기건가강중건ACL,유리우회복슬관절적은정성.
Objective To discuss clinical results of arthroscopic augmented reconstruction of partial anterior cruciate ligament (ACL) injury using autogenous hamstring tendons.Methods From January 2008 to March 2010 we treated 28 cases of partial ACL injury.They were 22 men and 6 women,aged from 21 to 51 years (average,31.2 years).All patients accepted arthroscopic augmented reconstruction using autogenous hamstring tendons with maintenance of normal ligament fibers.The femoral and tibia tunnels were made according to the native footprint of the injured part of ACL fibers with a 6-7 mm cannulated reamer.The autogenous semitendinosus or gracilis was removed and prepared to reconstruct the injured part of ACL.Results The patients were followed up for 27 to 54 months (average,33.6 months).After operation all cases had negative results of Lachman test and 24 of them had hard ends.Negative results of pivot shift test were maintained in 25 patients; 3 patients had 1 + pivot shift.The KT-1000 side to side difference measurements decreased significantly from preoperative 2.1 ±0.4 mm to postoperative 0.6 ±0.3 mm(t =16.141,P =0.000).The Lysholm score improved significantly from preoperative 72.8 ± 8.6 points to postoperative 97.1 ± 2.2 points(t =13.793,P =0.000).Conclusion Arthroscopic augmented reconstruction using autogenous hamstring tendons with maintenance of normal ligament fibers can contribute to the recovery of knee joint stability after partial ACL injury.