CAJ | 학술논문

目的：探讨前交叉韧带( anterior cruciate ligament，ACL )合并半月板损伤同期修复的临床疗效。方法对2005年10月至2013年12月，我院经治的139例 ACL 合并半月板损伤患者，进行随访。男98例，女41例；年龄13～71岁，平均31.2岁。左膝62例，右膝77例，病程5天～1.6年。临床主要表现为膝关节不稳，疼痛，弹响，绞锁。本组均采用同期 ACL 重建合并半月板缝合术治疗，术前、术后采用 Lysholm 评分及 IKDC 评分评价膝关节功能，根据 Barrett 标准评判半月板愈合情况。结果本组139例，术后切口均 I 期愈合，术后无血管、神经等并发症发生。139例均随访11个月～9年，平均3年，术后3、6、12、24、36个月 Lysholm 评分依次为：62.36±3.24，79.46±1.28，88.64±4.06，94.36±2.42，94.48±4.28较术前(32.66±3.42)明显提高(P3＝0.000，P6＝0.000，P12＝0.000，P24＝0.000，P36＝0.000)，术后3、6、12、24、36个月 IKDC 评分依次为：68.86±2.38，80.05±0.91，90.48±3.66，95.56±3.28，96.64±3.36，较术前(38.48±4.32)明显改善(P3＝0.000，P6＝0.000，P12＝0.000，P24＝0.000，P36＝0.000)。半月板愈合136例，3例陈旧性桶柄状撕裂术后有活动后中度疼痛，愈合率97.84%。结论 ACL 合并半月板损伤应早期修复；同期修复 ACL 合并半月板损伤术后膝关节功能恢复好，愈合率高，临床效果满意。
목적：탐토전교차인대( anterior cruciate ligament，ACL )합병반월판손상동기수복적림상료효。방법대2005년10월지2013년12월，아원경치적139례 ACL 합병반월판손상환자，진행수방。남98례，녀41례；년령13～71세，평균31.2세。좌슬62례，우슬77례，병정5천～1.6년。림상주요표현위슬관절불은，동통，탄향，교쇄。본조균채용동기 ACL 중건합병반월판봉합술치료，술전、술후채용 Lysholm 평분급 IKDC 평분평개슬관절공능，근거 Barrett 표준평판반월판유합정황。결과본조139례，술후절구균 I 기유합，술후무혈관、신경등병발증발생。139례균수방11개월～9년，평균3년，술후3、6、12、24、36개월 Lysholm 평분의차위：62.36±3.24，79.46±1.28，88.64±4.06，94.36±2.42，94.48±4.28교술전(32.66±3.42)명현제고(P3＝0.000，P6＝0.000，P12＝0.000，P24＝0.000，P36＝0.000)，술후3、6、12、24、36개월 IKDC 평분의차위：68.86±2.38，80.05±0.91，90.48±3.66，95.56±3.28，96.64±3.36，교술전(38.48±4.32)명현개선(P3＝0.000，P6＝0.000，P12＝0.000，P24＝0.000，P36＝0.000)。반월판유합136례，3례진구성통병상시렬술후유활동후중도동통，유합솔97.84%。결론 ACL 합병반월판손상응조기수복；동기수복 ACL 합병반월판손상술후슬관절공능회복호，유합솔고，림상효과만의。
Objective To explore clinical effects of simultaneous anterior cruciate ligament ( ACL ) reconstruction and meniscus suture.Methods One hundred and thirty-nine patients with ACL and meniscus injury being admitted into our hospital from October, 2005 to December, 2013 were studied, including 98 males and 41 females. The average age was 31.2 years old ( range: 13-71 years ). There were 62 left knees, 77 right knees with the course of disease 5 days-1.6 years. All patients were performed ACL reconstruction and meniscus suture simultaneously. Main clinical manifestations were knee joint instability, pain, joint clicking, and locking. Results were assessed by Lysholm and IKDC knee-joint score system before and after operations. Barrett standard was used to evaluate clinical effects. Results All incisions healed primarily, no neurological or vascular injury were found. All 139 patients were followed up with the mean period of 3 years ( range: 11 months-9 years ). Lysholm increased from 32.66±3.42 to 62.36±3.24 3 months after the operation, 6 months to 79.46±1.28, 12 months to 88.64±4.06, 24 months to 94.36±2.42, 36 months to 94.48±4.28 (P3=0.000,P6=0.000,P12=0.000,P24=0.000,P36=0.000 ). IKDC increased from 38.48±4.32 to 68.86±2.38 3 months after the operation, 6 months to 80.05±0.91, 12 months to 90.48±3.66, 24 months to 95.56±3.28, 36 months to 96.64±3.36 (P3=0.000,P6=0.000,P12=0.000,P24=0.000,P36=0.000 ). Meniscus healed in 136 cases. Three cases of chronic bucket-handle tears had moderate pain after exercises postoperatively. Healing rate was 97.84%.Conclusions ACL and meniscus injury should be repaired at early stage. Simultaneous ACL reconstruction combined with meniscus suture has better post-operative joint functions and higher healing rate. Clinical effects are satisfactory.