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使用涤纶韧带假体进行前交叉韧带重建:一项长期研究。

Anterior cruciate reconstruction using a Dacron ligament prosthesis. A long-term study.

作者信息

Richmond J C, Manseau C J, Patz R, McConville O

机构信息

Department of Orthopaedic Surgery, New England Medical Center Hospital, Boston, Massachusetts.

出版信息

Am J Sports Med. 1992 Jan-Feb;20(1):24-8. doi: 10.1177/036354659202000107.

Abstract

A single-center prospective study is presented on 35 patients who underwent anterior cruciate ligament reconstruction using a Dacron ligament prosthesis. All of the reconstructions were performed by the same surgeon, using the same technique. All of the patients had a history of symptomatic chronic ACL insufficiency. The mean follow-up interval for all patients was 50 months. There was an overall failure rate of 37.1% (13 patients), based on the presence of at least one of the following criteria: the presence of a pivot shift; a 2+ or greater anterior drawer or Lachman; instrumented laxity of greater than 3 mm side-to-side translation in 20 degrees of flexion at 89 N; or by arthroscopic documentation. Six of these 13 patients were documented by arthroscopy and 7 were clinical failures. There were 26 patients with only anterior cruciate ligament laxity, and 9 patients with multiple instabilities or failed previous ACL reconstruction ("salvage"). In the group with isolated anterior cruciate ligament insufficiency, the failure rate was 23% (6 patients). In the salvage group, the failure rate was 78% (7 patients). There was a significant improvement in patient performance with respect to clinical laxity, Lysholm scores, and Tegner activity levels at 2 years postoperatively. There has been a subsequent deterioration in the performance of these patients through time.

摘要

本文介绍了一项单中心前瞻性研究,该研究纳入了35例使用涤纶韧带假体进行前交叉韧带重建的患者。所有重建手术均由同一位外科医生采用相同技术完成。所有患者均有症状性慢性前交叉韧带功能不全病史。所有患者的平均随访时间为50个月。基于以下至少一项标准,总体失败率为37.1%(13例患者):存在轴移;前抽屉试验或Lachman试验为2+或更严重;在89 N力作用下,20度屈曲时仪器测量的侧方平移松弛度大于3 mm;或通过关节镜检查记录。这13例患者中,6例经关节镜检查证实,7例为临床失败。26例患者仅存在前交叉韧带松弛,9例患者存在多种不稳定情况或既往前交叉韧带重建失败(“挽救手术”)。在单纯前交叉韧带功能不全组,失败率为23%(6例患者)。在挽救手术组,失败率为78%(7例患者)。术后2年,患者在临床松弛度、Lysholm评分和Tegner活动水平方面有显著改善。随着时间推移,这些患者的表现随后出现恶化。

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