| 由外向内与经胫骨建立股骨隧道保留残迹重建前交叉韧带的病例对照研究 |
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投稿时间：2013-02-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 孙磊 |
SUN Lei |
解放军第88医院全军骨科中心, 山东 泰安 271000 |
Orthopaedics Center of PLA, the 88 th Hospital of PLA, Tai'an 271000, Shandong, China |
sl88h@163.com |
| 吴波 |
WU Bo |
解放军第88医院全军骨科中心, 山东 泰安 271000 |
Orthopaedics Center of PLA, the 88 th Hospital of PLA, Tai'an 271000, Shandong, China |
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| 罗永忠 |
LUO Yong-zhong |
解放军第88医院全军骨科中心, 山东 泰安 271000 |
Orthopaedics Center of PLA, the 88 th Hospital of PLA, Tai'an 271000, Shandong, China |
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| 刘欣欣 |
LIU Xin-xin |
解放军第88医院全军骨科中心, 山东 泰安 271000 |
Orthopaedics Center of PLA, the 88 th Hospital of PLA, Tai'an 271000, Shandong, China |
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| 李岩 |
LI Yan |
解放军第88医院全军骨科中心, 山东 泰安 271000 |
Orthopaedics Center of PLA, the 88 th Hospital of PLA, Tai'an 271000, Shandong, China |
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| 期刊信息：《中国骨伤》2013年，第26卷，第5期，第397-401页 |
| DOI：10.3969/j.issn.1003-0034.2013.05.011 |
| 基金项目: |
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中文摘要:
目的: 探讨关节镜下由外向内与经胫骨隧道建立股骨隧道保留残迹重建前交叉韧带( ACL)的临床效果。
方法: 自2005年6月至2012年1月, 采用关节镜下保留残迹重建ACL 145例, 由外向内建立胫骨和股骨隧道88例(由外向内组),男55例, 女33例, 年龄18～52岁, 平均(29.22 ±7.31)岁;经胫骨隧道建立股骨隧道57例(经胫骨组),男35例, 女22例, 年龄18～51岁, 平均(29.28±8.07)岁。对两组术前、术后早期及随访时的Lysholm、VAS评分及IKDC分级等进行比较。
结果: 由外向内组手术时间(76.94±10.83) min,经胫骨组(70.35±10.11) min,经胫骨组手术时间短于由外向内组。两组术后早期关节积液反应差异无统计学意义(P=0.065).随访18～60个月, 两组患者的关节稳定性均较术前提高;由外向内组Lysholm评分由术前54.75±10.58,增加至随访时95.80±5.16;经胫骨组Lysholm评分由术前52.51±11.38,增加至随访时94.86±5.50;此外, 两组IKDC评级均较术前有显着改善。随访时两组间比较, 轴移试验、Lachman试验和前抽屉试验的稳定性差异无统计学意义, Lysholm评分和IKDC评级差异亦无统计学意义。
结论: 由外向内技术建立股骨隧道具有容易达到解剖位重建、对关节内干扰小的优点, 但技术操作较复杂。而经胫骨技术操作方便, 手术时间较短。依据实际情况选择相应的任何一种技术方法, 均能取得满意的临床效果。 |
| 【关键词】膝关节 前交叉韧带 修复外科手术 关节镜 病例对照研究 |
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| Case-control studies on therapeutic effects of arthroscopic reconstruction of anterior cruciate ligament with preservation of remnant through outside-in and transtibial tunel |
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ABSTRACT
Objective: To compare the properties and clinical outcomes of arthroscopic reconstruction of anterior cruciate ligament (ACL) with preservation of remnant through outside-in and transtibial tunel.
Methods: From June 2005 to January 2012,145 patients were treated with arthroscopic reconstruction of ACL with preservation of remnant. Among the patients,88 patients were treated with outside-in techniques(outside-in group),including 55 males and 33 females,ranging in age from 18 to 52 years,with a mean of (29.22 ±7.31) years; 57 patients were treated with transtibial technique(transtibial group),including 35 males and 22 females,ranging in age from 18 to 51 years,with a mean of(29.28±8.07)years. The Lysholm,VAS and IKDC scores were compared between two groups before operation,after operation and at the latest follow-up time.
Results: The average operation time was(76.94±10.83) min in the outside-in group,and (70.35±10.11) min in the transbibial group,there was a significant difference between two groups. There was no significant difference of hydrops articuli scores at the early stage between the two groups (P=0.065). At follow-up from 18 to 60 months,there were great improvements in the knee stabilities in each group compared with the preoperative data respectively. The Lysholm score improved from 54.75±10.58 preoperatively to 95.80±5.16 at the follow-up in the outside-in group; and improved from 52.51±11.38 preoperatively to 94.86±5.50 at follow-up in the transtibial group. Additionally,IKDC grades also improved in both groups. However,no significant differences were seen in stabilities shown by pivot shift test,Lachman test and anterior drawer test. And there also no significant differences of Lysholm scores and IKDC grades between two groups after operation.
Conclusion: The outside-in technique has advantages to create an anatomical femoral tunnel easily with minimal intra-articular interference,and disadvantages of complicated manipulation. The transtibial technique is easy to operate and gain time. Using either of responding technique according to the actual situation,satisfactory outcome could be archived. |
| KEY WORDS Knee joint Anterior cruciate ligament Reconstructive surgical procedures Arthroscopes Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 孙磊,吴波,罗永忠,刘欣欣,李岩.由外向内与经胫骨建立股骨隧道保留残迹重建前交叉韧带的病例对照研究[J].中国骨伤,2013,26(5):397~401 |
| 英文格式: | SUN Lei,WU Bo,LUO Yong-zhong,LIU Xin-xin,LI Yan.Case-control studies on therapeutic effects of arthroscopic reconstruction of anterior cruciate ligament with preservation of remnant through outside-in and transtibial tunel[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(5):397~401 |
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