CAJ | 학술논문

目的观察关节镜下应用横穿钉固定(Transfix)+界面螺钉+门型钉固定自体腘绳肌腱重建膝关节前交叉韧带(anterior cruciate ligament,ACL)的临床疗效.方法对本院2010年6月-2011年4月56例膝关节ACL断裂患者取自体腘绳肌腱作移植物,关节镜下应用股骨端横穿钉固定(Transfix),胫骨端界面螺钉+门型钉固定行ACL单束重建,通过关节活动度、前抽屉试验(anterior drawer test,ADT)、Lachman试验、轴移试验、单腿跳跃试验、Lysholm评分、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)2000主观膝关节评分及膝关节动度仪KT1000对术后临床疗效进行观察.结果所有患者均获得随访,随访13~24个月(平均15.6个月).Lysholm评分由术前(57.71±7.45)分提高到末次随访时的(92.34±3.84)分(P <0.001);IKDC 2000评分由术前(69.86±8.95)分提高到末次随访时的(90.23±5.14)分(P <0.001);膝关节动度仪KT1000由术前的(6.38±2.31) mm降低至末次随访时的(2.72±1.12) mm(P<0.001).结论关节镜下应用Transfix系统固定自体腘绳肌腱重建ACL近期临床疗效满意,移植物固定可靠,手术操作简单安全,术后恢复快.
목적관찰관절경하응용횡천정고정(Transfix)+계면라정+문형정고정자체객승기건중건슬관절전교차인대(anterior cruciate ligament,ACL)적림상료효.방법대본원2010년6월-2011년4월56례슬관절ACL단렬환자취자체객승기건작이식물,관절경하응용고골단횡천정고정(Transfix),경골단계면라정+문형정고정행ACL단속중건,통과관절활동도、전추체시험(anterior drawer test,ADT)、Lachman시험、축이시험、단퇴도약시험、Lysholm평분、국제슬관절문헌위원회(International Knee Documentation Committee,IKDC)2000주관슬관절평분급슬관절동도의KT1000대술후림상료효진행관찰.결과소유환자균획득수방,수방13~24개월(평균15.6개월).Lysholm평분유술전(57.71±7.45)분제고도말차수방시적(92.34±3.84)분(P <0.001);IKDC 2000평분유술전(69.86±8.95)분제고도말차수방시적(90.23±5.14)분(P <0.001);슬관절동도의KT1000유술전적(6.38±2.31) mm강저지말차수방시적(2.72±1.12) mm(P<0.001).결론관절경하응용Transfix계통고정자체객승기건중건ACL근기림상료효만의,이식물고정가고,수술조작간단안전,술후회복쾌.
Objective To observe the clinical therapeutic effect of arthroscopic transfix system+interference screw+spiked ligament staple fixation with autologous hamstring tendon on anterior cruciate ligament (ACL) reconstruction. Methods Fifty-six patients with ACL fragmentation admitted to our hospital from June 2010 to April 2011 underwent transfix system fixation at the femoral side,interference screw and spiked ligament staple fixation at the tibial side for single bundle ACL reconstruction with autologous hamstring tendon. Their clinical therapeutic effects were observed by knee motion test, anterior drawer test (ADT), Lachman test, pivot shift test, one-leg hop test, Lysholm score, and International Knee Documentation Committee(IKDC) 2000 subjective knee score and knee motion KT1000 arthrometry after operation. Results The patients were followed up for 13-24 months (average 15.6 months). Their Lysholm score and IKDC score were significantly higher after operation than before operation (92.34±3.84 vs 57.71±7.45, 90.23±5.14 vs 69.86±8.95, P<0.001), whereas their KT1000 arthrometry length was significantly shorter at the last follow-up than before operation (2.72±1.12 mm vs 6.38±2.31 mm, P<0.001). Conclusion Arthroscopic transfix system fixation with autologous hamstring tendon is a simple procedure for ACL reconstruction with a satisfactory short-term clinical curative effect, a reliable fixation of implants, and a rapid recovery of the patients after operation.