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前交叉韧带的射频电热收缩术

Radiofrequency electrothermal shrinkage of the anterior cruciate ligament.

作者信息

Carter Thomas R, Bailie David S, Edinger Samantha

机构信息

The Orthopedic Clinic Association, Phoenix. Arizona State University, Tempe, Arizona 85281, USA.

出版信息

Am J Sports Med. 2002 Mar-Apr;30(2):221-6. doi: 10.1177/03635465020300021301.

Abstract

The efficacy of electrothermal collagen shrinkage in the treatment of patients with anterior cruciate ligament laxity was evaluated. Eighteen patients who had continuity of the anterior cruciate ligament but had symptomatic laxity were treated with arthroscopic electrothermal shrinkage of the anterior cruciate ligament using a monopolar radiofrequency probe. The mean length of follow-up in patients whose stability was maintained was 20.5 months. Seven of the patients had undergone previous reconstruction, four with patellar tendon graft and three with quadrupled hamstring tendon graft. Laxity was chronic in nine patients and acute in nine. The KT-1000 arthrometer results at 1 month postoperatively revealed decreased anterior excursion, with an average side-to-side difference of 1.9 mm. However, 11 patients had a failed result at an average 4.0 months. Of the seven patients with successful results, six had native ligaments and had been treated for acute laxity and one had a patellar tendon graft and had been treated for chronic laxity. Even with the short-term follow-up in our study, it is evident that thermal shrinkage using radiofrequency technology has limited application for patients with anterior cruciate ligament laxity. Although it may be useful in treating patients with an acutely injured native anterior cruciate ligament, further study is needed to see if the ligament stretches out over time or is at increased risk of reinjury.

摘要

评估了电热胶原皱缩术治疗前交叉韧带松弛患者的疗效。18例前交叉韧带连续但有症状性松弛的患者,使用单极射频探头通过关节镜对前交叉韧带进行电热皱缩治疗。稳定性得以维持的患者平均随访时间为20.5个月。其中7例患者曾接受过重建手术,4例采用髌腱移植,3例采用四股绳肌腱移植。9例患者为慢性松弛,9例为急性松弛。术后1个月时KT-1000关节测量仪结果显示前向移动减少,平均左右差值为1.9mm。然而,11例患者平均在4.0个月时治疗失败。在7例治疗成功的患者中,6例为天然韧带且治疗的是急性松弛,1例采用髌腱移植且治疗的是慢性松弛。即使在我们研究的短期随访中,也明显可见射频技术的热皱缩术在前交叉韧带松弛患者中的应用有限。尽管它可能对急性损伤的天然前交叉韧带患者有用,但还需要进一步研究以确定韧带是否会随时间延长而伸展或再次受伤的风险是否增加。

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