CAJ | 학술논문

目的比较采用关节镜下经胫骨隧道技术和切开胫骨镶嵌骨块技术重建基于后十字韧带的多发韧带损伤患者术后的后向稳定性和临床疗效.方法自2005年4月至2009年12月,共连续完成基于后十字韧带的多发韧带损伤重建修复手术135例,2年以上随访者88例.后十字韧带采用关节镜下经胫骨隧道技术重建57例(64.8％),切开镶嵌骨块技术重建31例(35.2％),合并损伤予同期重建或修复.随访时间平均(45.9±17.0)个月(24～77个月).采用KT-1000和Telos应力装置测量手术前后膝关节后向稳定性.采用Tegner、Lysholm、AAOS评分评价临床疗效.结果两组患者的性别、年龄、受伤至手术时间、合并损伤和主观评分比较,差异均无统计学意义.经胫骨隧道组术前KT-1000两侧差值为(13.5±4.8) mm,术后为(2.4±3.4)mm；术前Telos两侧差值为(14.9±7.1) mm,术后为(4.6±4.0) mm.切开胫骨镶嵌骨块组术前KT-1000两侧差值为(13.7±5.2) mm,术后为(2.2±3.6)mm;术前Telos两侧差值为(14.9±5.9) mm,术后为(4.3±3.9) mm.两组患者KT-1000和Telos两侧差值手术前后组内比较差异均有统计学意义,而组间比较差异均无统计学意义.两组患者术后Tegner、Lysholm、AAOS评分的差异均无统计学意义.结论采用两种技术重建基于后十字韧带的多发韧带损伤,两组患者术后的后向稳定性及功能评分差异均无统计学意义,且均可明显恢复膝关节后向稳定性.
목적 비교채용관절경하경경골수도기술화절개경골양감골괴기술중건기우후십자인대적다발인대손상환자술후적후향은정성화림상료효.방법 자2005년4월지2009년12월,공련속완성기우후십자인대적다발인대손상중건수복수술135례,2년이상수방자88례.후십자인대채용관절경하경경골수도기술중건57례(64.8％),절개양감골괴기술중건31례(35.2％),합병손상여동기중건혹수복.수방시간평균(45.9±17.0)개월(24～77개월).채용KT-1000화Telos응력장치측량수술전후슬관절후향은정성.채용Tegner、Lysholm、AAOS평분평개림상료효.결과 량조환자적성별、년령、수상지수술시간、합병손상화주관평분비교,차이균무통계학의의.경경골수도조술전KT-1000량측차치위(13.5±4.8) mm,술후위(2.4±3.4)mm；술전Telos량측차치위(14.9±7.1) mm,술후위(4.6±4.0) mm.절개경골양감골괴조술전KT-1000량측차치위(13.7±5.2) mm,술후위(2.2±3.6)mm;술전Telos량측차치위(14.9±5.9) mm,술후위(4.3±3.9) mm.량조환자KT-1000화Telos량측차치수술전후조내비교차이균유통계학의의,이조간비교차이균무통계학의의.량조환자술후Tegner、Lysholm、AAOS평분적차이균무통계학의의.결론 채용량충기술중건기우후십자인대적다발인대손상,량조환자술후적후향은정성급공능평분차이균무통계학의의,차균가명현회복슬관절후향은정성.
Objective To compare stability between the traditional endoscopic technique and thetibial inlay in treatment of posterior cruciate ligament (PCL) reconstruction.Methods Between April 2005 and December 2009,135 patients underwent surgery for PCL in multiple-ligament injuries,and only 88 (65.2％) patients were followed up longer than 2 years.The follow-up time ranged 24 to 77 months (mean,45.9 months).Fifty-seven cases (64.8％) were treated with endoscopic transtibial PCL reconstructions,and 31(35.2％) received tibial inlay.Each patient was evaluated using the Tegner,Lysholm,and American Academy of Orthopaedic Surgeons (AAOS) knee-rating scales,KT-1000 arthrometry and Telos.Results The preoperative KT-1000 measurement was (13.5±4.8) mm (transtibial) and (13.7±5.2) mm (inlay).The postoperative KT-1000 measurement was (2.4±3.4) mm (transtibial) and (2.2±3.6) mm (inlay).The preoperative Telos measurement was (14.9±7.1) mm (transtibial) and (14.9±5.9) mm (inlay).The postoperative Telos measurement was (4.6±4.0) mm (transtibial) and (4.3±3.9) mm (inlay).There were significant differences (P＜0.01) in KT-1000 and Telos between pre-and post-operative measurement,while it does not reach statistical significance (P=0.880,0.956,0.744,0.647) in KT-1000 and Telos when comparing transtibial and inlay technique.There were no significant differences in sex,age,time from injury to surgery,combined injuries or Lysholm,Tegner,AAOS knee score between two groups.Conclusion There was no important advantage of one technique over the other.Transtibial or inlay technique for PCL reconstruction can restore anteroposterior knee stability.