中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
39期
6251-6255
,共5页
陈辉%王群%燕双喜%董天云%邹海兵
陳輝%王群%燕雙喜%董天雲%鄒海兵
진휘%왕군%연쌍희%동천운%추해병
骨科植入物%人工假体%退行性股骨髁间窝前交叉韧带撞击症%膝关节置换%AO空心螺钉内固定%并发症
骨科植入物%人工假體%退行性股骨髁間窩前交扠韌帶撞擊癥%膝關節置換%AO空心螺釘內固定%併髮癥
골과식입물%인공가체%퇴행성고골과간와전교차인대당격증%슬관절치환%AO공심라정내고정%병발증
Anterior Cruciate Ligament%Arthroplasty,Replacement,Knee%Bone Nails%Postoperative Complications
背景:传统上对退行性股骨髁间窝前交叉韧带撞击症采用非手术治疗,但是可造成交叉韧带功能的丧失,引起膝关节不稳等并发症。随着医学技术的发展,越来越多的观点主张对于韧带损伤及合并膝关节其他结构损伤应尽早手术治疗。<br> 目的:探讨膝关节置换对退行性股骨髁间窝前交叉韧带撞击症的修复效果,并与AO空心螺钉内固定对比。方法:纳入退行性股骨髁间窝前交叉韧带撞击症患者72例,根据随机抽签法分为治疗组与对照组,每组36例。对照组采用切开AO空心螺钉内固定治疗,治疗组采用膝关节置换治疗。治疗后7 d评定患者的修复效果;在治疗前与治疗后7 d根据Lysholm膝关节评分和国际膝关节文献委员会制定的膝关节评估表(IKDC)评分进行膝关节功能评定;治疗后对所有患者进行6个月的随访,调查并发症发生情况。<br> 结果与结论:所有患者均顺利完成手术。治疗后7 d治疗组的疗效优良率为94%,对照组为75%,治疗组明显高于对照组(P <0.05)。治疗后7 d治疗组的Lysholm评分明显高于治疗前,而IKDC评分明显低于治疗前,对比差异有显著性意义(P <0.05);同时治疗后7 d治疗组的Lysholm评分和IKDC评分均优于对照组,差异有显著性意义(P <0.05)。随访6个月,治疗组患者的切口感染、关节腔感染、关节疼痛、深静脉血栓等并发症发生率明显低于对照组(P<0.05)。提示膝关节置换治疗退行性股骨髁间窝前交叉韧带撞击症能提高近期疗效,有效恢复膝功能,同时减少置换后并发症的发生。
揹景:傳統上對退行性股骨髁間窩前交扠韌帶撞擊癥採用非手術治療,但是可造成交扠韌帶功能的喪失,引起膝關節不穩等併髮癥。隨著醫學技術的髮展,越來越多的觀點主張對于韌帶損傷及閤併膝關節其他結構損傷應儘早手術治療。<br> 目的:探討膝關節置換對退行性股骨髁間窩前交扠韌帶撞擊癥的脩複效果,併與AO空心螺釘內固定對比。方法:納入退行性股骨髁間窩前交扠韌帶撞擊癥患者72例,根據隨機抽籤法分為治療組與對照組,每組36例。對照組採用切開AO空心螺釘內固定治療,治療組採用膝關節置換治療。治療後7 d評定患者的脩複效果;在治療前與治療後7 d根據Lysholm膝關節評分和國際膝關節文獻委員會製定的膝關節評估錶(IKDC)評分進行膝關節功能評定;治療後對所有患者進行6箇月的隨訪,調查併髮癥髮生情況。<br> 結果與結論:所有患者均順利完成手術。治療後7 d治療組的療效優良率為94%,對照組為75%,治療組明顯高于對照組(P <0.05)。治療後7 d治療組的Lysholm評分明顯高于治療前,而IKDC評分明顯低于治療前,對比差異有顯著性意義(P <0.05);同時治療後7 d治療組的Lysholm評分和IKDC評分均優于對照組,差異有顯著性意義(P <0.05)。隨訪6箇月,治療組患者的切口感染、關節腔感染、關節疼痛、深靜脈血栓等併髮癥髮生率明顯低于對照組(P<0.05)。提示膝關節置換治療退行性股骨髁間窩前交扠韌帶撞擊癥能提高近期療效,有效恢複膝功能,同時減少置換後併髮癥的髮生。
배경:전통상대퇴행성고골과간와전교차인대당격증채용비수술치료,단시가조성교차인대공능적상실,인기슬관절불은등병발증。수착의학기술적발전,월래월다적관점주장대우인대손상급합병슬관절기타결구손상응진조수술치료。<br> 목적:탐토슬관절치환대퇴행성고골과간와전교차인대당격증적수복효과,병여AO공심라정내고정대비。방법:납입퇴행성고골과간와전교차인대당격증환자72례,근거수궤추첨법분위치료조여대조조,매조36례。대조조채용절개AO공심라정내고정치료,치료조채용슬관절치환치료。치료후7 d평정환자적수복효과;재치료전여치료후7 d근거Lysholm슬관절평분화국제슬관절문헌위원회제정적슬관절평고표(IKDC)평분진행슬관절공능평정;치료후대소유환자진행6개월적수방,조사병발증발생정황。<br> 결과여결론:소유환자균순리완성수술。치료후7 d치료조적료효우량솔위94%,대조조위75%,치료조명현고우대조조(P <0.05)。치료후7 d치료조적Lysholm평분명현고우치료전,이IKDC평분명현저우치료전,대비차이유현저성의의(P <0.05);동시치료후7 d치료조적Lysholm평분화IKDC평분균우우대조조,차이유현저성의의(P <0.05)。수방6개월,치료조환자적절구감염、관절강감염、관절동통、심정맥혈전등병발증발생솔명현저우대조조(P<0.05)。제시슬관절치환치료퇴행성고골과간와전교차인대당격증능제고근기료효,유효회복슬공능,동시감소치환후병발증적발생。
BACKGROUND:Traditionaly, non-surgical treatment was used to treat degenerative femoral intercondylar fossa impingement syndrome, but it can cause function loss of cruciate ligament, or knee instability. With the development of medical technology, more and more views believed that ligament damage and combined with other knee structural damage should receive surgery as soon as possible. <br> OBJECTIVE: To investigate the repair effect of knee arthroplasty for treating degenerative femoral intercondylar fossa impingement syndrome, and compare with AO cannulated screw fixation. <br> METHODS:A total of 72 patients with degenerative femoral intercondylar fossa impingement syndrome were equaly and randomly divided into treatment group and control group. Patients in the control group were treated with open AO cannulated screw fixation, and patients in the treatment group were subjected to knee arthroplasty. At 7 days after treatment, repair effect was evaluated. Before treatment and 7 days after treatment, knee function was assessed by using Lysholm knee Scoring Scale and the international knee documentation committee knee evaluation form. Al patients were folowed up for 6 months after treatment to investigate the occurrence of complications. <br> RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. At 7 days after treatment, the excelent and good rate was 94% in the treatment group and 75% in the control group. The excelent and good rate was significantly higher in the treatment group than in the control group (P < 0.05). Lysholm scores were significantly greater, but the international knee documentation committee knee evaluation form scores were significantly lower at 7 days after treatment compared with that before treatment in the treatment group (P < 0.05). Simultaneously, Lysholm scores and the international knee documentation committee knee evaluation form scores were significantly better in the treatment group than in the control group at 7 days after treatment (P < 0.05). During 6-month folow-up, wound infection, intra-articular infection, joint pain, and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). These findings indicate that knee arthroplasty for degenerative femoral intercondylar fossa impingement syndrome can improve short-term efficacy, effectively restore knee function and reduce the incidence of postoperative complications.