关节镜下前交叉韧带重建术后失败行翻修术的近中期临床疗效

任忠明, 谢国庆, 金文孝, 申世源, 吴鹏, 杨坤

武警医学 ›› 2020, Vol. 31 ›› Issue (8) : 654-656.

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武警医学 ›› 2020, Vol. 31 ›› Issue (8) : 654-656.
论著

关节镜下前交叉韧带重建术后失败行翻修术的近中期临床疗效

  • 任忠明, 谢国庆, 金文孝, 申世源, 吴鹏, 杨坤
作者信息 +

Early and medium-term clinical effects of reconstruction of anterior cruciate ligaments

  • REN Zhongming, XIE Guoqing, JIN Wenxiao, SHEN Shiyuan, WU Peng, YANG Kun
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摘要

目的 探讨关节镜下前交叉韧带重建术后失败行翻修术的近中期临床疗效。方法 回顾性分析武警海警总队医院2013-02至2019-02收治的前交叉韧带重建术后失败行翻修术患者30例(30膝)临床资料,术后平均随访时间37个月(6~70个月)。手术前后膝关节功能采用Lysholm评分、Tegner评分、IKDC评分、KT-2000差值进行分析,采用Lachman试验、前抽屉试验对手术前后膝关节前方稳定性进行分析。结果 Lysholm评分术前(48.33±5.43)分,末次随访(82.92±4.13)分;Tegner评分术前(2.18±0.91)分,末次随访(6.52±1.12)分;IKDC评分术前(48.32±5.54)分,末次随访(76.45±3.86)分;KT-2000屈曲90°差值术前(6.95±1.21)mm,末次随访(2.23±0.84)mm,KT-2000屈曲30°差值术前(6.62±1.01)mm,末次随访(2.34±0.42)mm;差异均有统计学意义(P<0.05)。Lachman试验、前抽屉试验术前30例全部阳性,术后全部阴性,膝关节功能术后提高明显。结论 前交叉韧带重建术后失败行翻修术,近中期疗效满意。

Abstract

Objective To evaluate the clinical effects of reconstruction of anterior cruciate ligaments(ACLs).Methods Between February 2013 and February 2019, 30 patients (30 knees) underwent revision surgery after ACL reconstruction failure. All the patients were followed up for 37 months on average (ranging from 6 months to 70 months). The preoperative Lysholm score, Tegner score, IKDC score and KT-2000 arthrometer side-to-side difference and those of the last follow-up were used to evaluate the clinical outcomes. The Lachman test and drawer test were used to evaluate the knee stability.Results The preoperative Lysholm score and that of the last follow-up were respectively (48.33±5.43) points and (82.92±4.13) points, compared to (2.18±0.91) points and (6.52±1.12) points respectively for the Tegner score, and (48.32±5.54) points and (76.45±3.86) points respectively for the IKDC score. The KT-2000 arthrometer side-to-side difference at 90°of flexion was (6.95±1.21) mm before operation, but (2.23±0.84) mm after operation, compared to (6.62±1.01) points before operation, and (2.34±0.42) points after operation at 30° of flexion. The difference was statistically significant (P<0.05). The preoperative Lachman test and drawer test were positive in 30 cases, but negative in all these cases postoperatively.Conclusions The effect of the revision surgery after ACL reconstruction failure is satisfactory.

关键词

关节镜 / 前交叉韧带 / 重建 / 翻修

Key words

arthroscopic / anterior cruciate ligament / reconstruction / revision

引用本文

导出引用
任忠明, 谢国庆, 金文孝, 申世源, 吴鹏, 杨坤. 关节镜下前交叉韧带重建术后失败行翻修术的近中期临床疗效[J]. 武警医学. 2020, 31(8): 654-656
REN Zhongming, XIE Guoqing, JIN Wenxiao, SHEN Shiyuan, WU Peng, YANG Kun. Early and medium-term clinical effects of reconstruction of anterior cruciate ligaments[J]. Medical Journal of the Chinese People Armed Police Forces. 2020, 31(8): 654-656
中图分类号: R684.3   

参考文献

[1] Yim J H, Seon J K, Kim Y k, et al. Anterior translation and rotational stability of anterior cruciate ligament-deficient knee during walking: speed and turning direction[J]. J Orthop Sci, 2015, 20(1):155-162.
[2] Shaerf D A, Pastides P S, Sarraf K M, et al. Anterior cruciate ligament reconstruction best practice: a review of graft choice[J].World J Orthop, 2014, 5: 23-29.
[3] Chang S, Egami D K, Shaieb M D, et al. Anterior cruciate ligament reconstruction: allograft versus autograft[J]. Arthroscopy, 2003, 19: 453-462.
[4] Tomohiro T, Yusuke H, Masatoshi T, et al. One-stage revision ACL reconstruction after primary ACL double bundle reconstruction: is bone-patella tendon-bone autograft reliable?[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 3: 23-29.
[5] Karaaslan F, Karaoglu S, Yurdakul E. Reducing intraarticular hemarthrosis after arthroscopic ACL reconstruction: response[J]. Am J Sports Med, 2016, 44(3): 9-10.
[6] Gifstad T, Foss O A, Engebretsen L, et al. Lower risk of revision with pattellar tendon autografts compared with hamstring autografts [J].Am J Sports Med, 2014, 42(10): 2319-2328.
[7] Taggart T F, Kumar A, Bickerstaff D R. Revision anterior cruciate ligament reconstruction: a midterm patient assessmnet [J].Knee, 2004, 11(1): 29-36.
[8] 曹红彬,梁 军,辛景义. 腓骨长肌腱重建治疗前交叉韧带损伤[J]. 中华医学杂志,2012,92(35): 2460-2462.
[9] Lubowitz J H, Schwartzberg R, Smith P. Randomized controlled trial comparing all-inside anterior cruciate ligament reconstruction technique with anterior cruciate ligament reconstruction with a full tibal tunnel[J]. Arthroscopy, 2013, 7: 1195-1200.
[10] 刘国强,尹文化,郭杰坤, 等.关节镜下同种异体韧带重建前交叉韧带的临床研究[J].中华关节外科杂志,2010, 4: 761-764.
[11] 牟岩涛,郝建学,杜乔伟. 应用自体和同种异体半肌腱重建兔前交叉韧带对血管生成状态的初步研究[J]. 武警医学,2015, 26(12):1259-1260.
[12] Batty L M, Norsworthy C J, Lash N J, et al. Synthehc devices for reconstruction surgery of the cruciate ligaments: a systematic review[J].Arthroscopy, 2015, 31(5):957-968.
[13] 陈 蓟,刘 弼. LARS人工韧带关节镜下一期同时重建前后交叉韧带的近期疗效分析[J].中华创伤骨科杂志,2017, 8: 727-729.
[14] Lubowitz J H. Editorial commentary: synthetic ACL grafts are more important than clinical nonbelievers may realize[J].Arthroscopy, 2015, 31(5): 967-970.
[15] 邱洪九,吴 毅,王子明,等. 3D打印导向器辅助关节镜下前交叉韧带重建术骨隧道准确性的对比研究[J]. 创伤外科杂志,2018, 20(9):651-655.
[16] 余 洋,李彦林,蔡国锋,等.3D打印个性化导板辅助前交叉韧带翻修术中股骨隧道定位1例报道[J].中国运动医学杂志,2018,37(8):692-693.
[17] Hu Y,Yuan Z S,Kepler C K, et al. Deviation analysis of atlantoaxial pedicle screws assissted by a drill template [J].Orthopedies, 2014, 37(5): 420-427.
[18] 敖英芳,马 勇,崔国庆,等. 前交叉韧带重建失败的原因分析[J]. 中华外科杂志,2007, 45(2):86-89.
[19] Antony A T, Owen R W. Two-stage revision anterior cruciate ligament reconstruction: our experience using allograft bone dowels[J].J Orthop Surg, 2019, 27(2):1-9.
[20] Behrens S B, Lee B J, Paller D, et al. Mechanical propeties of revision ACLreconstruction [J]. J Knee Surg, 2014, 27(2):119-124.

基金

浙江省嘉兴市公益性研究计划(2018AD32177)

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