CAJ | 학술논문

背景：对于合并交叉韧带损伤的年轻且运动水平较高的患者易出现Ⅲ度膝关节内侧副韧带损伤，直接修复损伤韧带以及肌肉肌腱转位加强等传统重建方法会遗留内侧副韧带复合体松弛的情况。目的：探讨自体肌腱移植修复膝关节内侧副韧带Ⅲ度损伤的效果。方法：对Ⅲ度膝关节内侧副韧带损伤患者47例采取修复重建方法治疗，在解剖修复内侧副韧带基础上游离移植自体半腱肌腱、骨-髌韧带-骨、腘绳肌腱重建内侧副韧带浅层。结果与结论：最终37例患者得到随访，随访时间平均48个月。37例患者Lysholm评分、IKDC评分、Tegner最终随访评分、外翻应力位X射线片内侧关节间隙较健侧增宽的距离均较重建前明显改善，差异均有显著性意义(P <0.05)。按临床疗效评分为重建后优12例，良18例，中4例，差3例，优良率81%。结果证实，自体肌腱移植修复膝关节内侧副韧带Ⅲ度损伤效果良好，骨-髌韧带-骨及腘绳肌腱均是可供选择的移植物。
배경：대우합병교차인대손상적년경차운동수평교고적환자역출현Ⅲ도슬관절내측부인대손상，직접수복손상인대이급기육기건전위가강등전통중건방법회유류내측부인대복합체송이적정황。목적：탐토자체기건이식수복슬관절내측부인대Ⅲ도손상적효과。방법：대Ⅲ도슬관절내측부인대손상환자47례채취수복중건방법치료，재해부수복내측부인대기출상유리이식자체반건기건、골-빈인대-골、객승기건중건내측부인대천층。결과여결론：최종37례환자득도수방，수방시간평균48개월。37례환자Lysholm평분、IKDC평분、Tegner최종수방평분、외번응력위X사선편내측관절간극교건측증관적거리균교중건전명현개선，차이균유현저성의의(P <0.05)。안림상료효평분위중건후우12례，량18례，중4례，차3례，우량솔81%。결과증실，자체기건이식수복슬관절내측부인대Ⅲ도손상효과량호，골-빈인대-골급객승기건균시가공선택적이식물。
BACKGROUND:Young patients with cruciate ligament injury and high activity levels are prone to grade III medial colateral ligament injury in knee joint. Conventional construction methods such as direct restoration of injured ligaments and muscle-tendon transposition may induce the loosening of medial colateral ligament complex. OBJECTIVE:To explore the clinical effect of autologous tendon transplantation for grade III medial colateral ligament injury of the knee joint. METHODS: Forty-seven patients with grade III medial colateral ligament rupture were treated by operative repair and reconstruction. After repairing the anatomical structure of medial colateral ligaments, we liberated organic semitendinous tendon, bone-patela tendon-bone, and hamstring tendon, to reconstruct superficial medial colateral ligament. RESULTS AND CONCLUSION:Thirty-seven patients were folowed up for 48 months. Preoperative Lysholm score, IKDC score, Tegner score at the final folow-up, and the widened medial joint space on valgus stress X-Ray films were significantly improved compared with before reconstruction (P < 0.05). According to clinical efficacy scores, 12 cases achieved excelent reconstruction, 18 cases achieved good reconstruction, 4 cases achieved moderate reconstruction, and 3 cases achieved poor reconstruction. The excelent and good rate was 82%. Medial colateral ligament reconstruction based on repairing the anatomical structure is effective and satisfactory. Autologous bone-patela tendon-bone or semitendinous tendon is a good choice for medial colateral ligament reconstruction.