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半腱肌-肯尼迪韧带增强装置用于前交叉韧带重建

Semitendinosus Kennedy ligament augmentation device anterior cruciate ligament reconstruction.

作者信息

Gómez-Castresana F B, Bastos M N, Sacristán C G

机构信息

Hospital Universitario de San Carlos, Servicio de Traumatologia, Universidad Complutense de Madrid, Spain.

出版信息

Clin Orthop Relat Res. 1992 Oct(283):21-33.

PMID:1395249
Abstract

This is a prospective study of 78 chronic unilateral isolated anterior cruciate ligament (ACL) patients who were treated with an arthroscopically-assisted reconstruction technique using the semitendinosus tendon, occasionally associated with the gracilis, augmented with the Kennedy-ligament augmentation device (LAD). There was a minimum two-year follow-up period (mean, 34.3 months; range, 24-50 months). Ligamentous surgery was always restricted to the ACL intraarticular reconstruction. Preoperative, intraoperative, and postoperative examinations at three, six, 12, 18, and 24 months, and every year thereafter, including subjective and objective evaluation with KT 1000 arthrometer laxity measurements, were completed. Two-year examination data were available on 77 (98.7%) of the 78 patients compared with preoperative data. The pivot shift (side-to-side difference) improved from 49.3% with Grade 0-1 to 92.2% with Grade 0-1. KT 1000 20-pound anterior drawer (greater than 5 mm side-to-side difference) improved from 49.3% (mean, 6 mm) to 91.1% (mean, 0.55 mm). KT 1000 maximum manual anterior drawer (greater than 5 mm side-to-side difference) improved from 21.9% (mean, 7.8 mm) to 97.4% (mean, 0.55 mm). After ACL reconstruction, 89.6% of patients had a full range of motion and only 10.3% had flexion contractures of less than 5 degrees; 5.2% of patients had mild effusion. Functional Lysholm knee scoring of 100 points improved from 7.7% scoring over 85 points preoperatively (mean, 66.5) to 92.1% postoperatively (mean, 95.6). Instability was controlled in 89.4% of the patients, and 71.4% have been involved in sports after injury. Anterior cruciate ligament reconstruction reduces pathologic laxity, improves lower-leg function, and minimizes flexion contracture and effusion.

摘要

这是一项针对78例慢性单侧孤立前交叉韧带(ACL)患者的前瞻性研究,这些患者接受了关节镜辅助下使用半腱肌腱重建技术的治疗,偶尔会联合股薄肌,并使用肯尼迪韧带增强装置(LAD)进行增强。随访期至少为两年(平均34.3个月;范围24 - 50个月)。韧带手术始终局限于ACL关节内重建。在术后3、6、12、18和24个月以及此后每年进行术前、术中和术后检查,包括使用KT 1000关节测压仪进行主观和客观评估以测量松弛度。与术前数据相比,78例患者中有77例(98.7%)获得了两年的检查数据。轴移(两侧差异)从术前0 - 1级的49.3%改善至术后0 - 1级的92.2%。KT 1000 20磅前抽屉试验(两侧差异大于5 mm)从49.3%(平均6 mm)改善至91.1%(平均0.55 mm)。KT 1000最大手动前抽屉试验(两侧差异大于5 mm)从21.9%(平均7.8 mm)改善至97.4%(平均0.55 mm)。ACL重建术后,89.6%的患者关节活动范围正常,仅有10.3%的患者存在小于5度的屈曲挛缩;5.2%的患者有轻度积液。功能Lysholm膝关节评分为100分的患者比例从术前超过85分的7.7%(平均66.5分)提高至术后的92.1%(平均95.6分)。89.4%的患者不稳定情况得到控制,71.4%的患者受伤后参与了体育活动。前交叉韧带重建可减轻病理性松弛,改善小腿功能,并将屈曲挛缩和积液降至最低。

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