CAJ | 학술논문

背景：目前，关节镜下前交叉韧带保残与非保残重建的优劣以及保残重建对本体感觉的影响尚无明确定论。目的：比较关节镜下前交叉韧带自体腘绳肌腱移植保残重建与非保残重建后膝关节功能及稳定性的1年随访。方法：回顾分析关节镜下前交叉韧带重建患者75例，其中非保残重建37例，保残重建38例，均使用自体腘绳肌腱作为移植物。治疗前及治疗后6个月、治疗后1年进行Lysholm评分，IKDC评分及KT2000检测评价患者膝关节功能及稳定性，并采用被动角度重复试验进行本体感觉测试。结果与结论：治疗后随访时间为12-20个月。两组患者治疗后6个月患膝关节活动度均已基本恢复正常，患膝治疗后6个月、治疗后1年Lysholm评分，IKDC评分及KT2000检测较治疗前均获改善(P <0.05)，两组之间差异无显著性意义。术后6个月及1年保残组健侧和患侧本体感觉偏差小于非保残组(P <0.05)。治疗后摄片检查发现两组各有2例患者胫骨骨道偏离理想位置，未见独眼畸形发生。结果表明，前交叉韧带自体腘绳肌腱移植保残重建有利于患者修复术后本体感觉的恢复，并不增加手术并发症的发生率。
배경：목전，관절경하전교차인대보잔여비보잔중건적우렬이급보잔중건대본체감각적영향상무명학정론。목적：비교관절경하전교차인대자체객승기건이식보잔중건여비보잔중건후슬관절공능급은정성적1년수방。방법：회고분석관절경하전교차인대중건환자75례，기중비보잔중건37례，보잔중건38례，균사용자체객승기건작위이식물。치료전급치료후6개월、치료후1년진행Lysholm평분，IKDC평분급KT2000검측평개환자슬관절공능급은정성，병채용피동각도중복시험진행본체감각측시。결과여결론：치료후수방시간위12-20개월。량조환자치료후6개월환슬관절활동도균이기본회복정상，환슬치료후6개월、치료후1년Lysholm평분，IKDC평분급KT2000검측교치료전균획개선(P <0.05)，량조지간차이무현저성의의。술후6개월급1년보잔조건측화환측본체감각편차소우비보잔조(P <0.05)。치료후섭편검사발현량조각유2례환자경골골도편리이상위치，미견독안기형발생。결과표명，전교차인대자체객승기건이식보잔중건유리우환자수복술후본체감각적회복，병불증가수술병발증적발생솔。
BACKGROUND:Currently, there is stil no clear conclusion on the pros and cons of arthroscopic anterior cruciate ligament reconstruction with or without stump preservation residues as wel as the impact of reconstruction with stump preservation on proprioceptive sensation. OBJECTIVE:To compare the curative effect of arthroscopic anterior cruciate ligament reconstruction with or without stump preservation on the function and stability of the knee joint during a 1-year folow-up. METHODS: A retrospective analysis of 75 cases of arthroscopic anterior cruciate ligament reconstruction was done, including 37 cases of anterior cruciate ligament reconstruction without stump preservation and 38 cases of anterior cruciate ligament reconstruction with stump preservation. Autologous hamstring tendons were selected as implants. Evaluation of preoperative (6 months before operation) and postoperative (6 months and 1 year after operation) knee function and stability was implemented on the basis of Lysholm scores, IKDC Scores and KT2000. The comparative analysis was carried out as wel on repeated passive angle for proprioception testing. RESULTS AND CONCLUSION:Al of the patients were folowed up for 12 to 20 months. Range of motion of the knee joint was basicaly restored in the two groups 6 months after operation. The results showed the Lysholm scores, IKDC scores and KT-2000 scores at 6 months and 1 year after operation were significantly improved in the two groups as compared with the preoperative data (P < 0.05), and there was no statisticaly difference between the two groups. The proprioception difference between the healthy and affected sides was lower in the patients with stump preservation than those without stump preservation at 6 months and 1 year after operation (P< 0.05). There were two cases in each group whose bone tunnel of the tibia was found deviating from the ideal position through postoperative X-ray examination, but cyclopia was unseen. Anterior cruciate ligament reconstruction with stump preservation is beneficial to the recovery of postoperative proprioception without increasing of postoperative complications.