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前交叉韧带重建中股骨生物可吸收交叉克氏针固定术

Femoral bioabsorbable cross-pin fixation in anterior cruciate ligament reconstruction.

作者信息

Ahn Jin Hwan, Park Jun Sic, Lee Yong Seuk, Cho Young Jin

机构信息

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Arthroscopy. 2007 Oct;23(10):1093-9. doi: 10.1016/j.arthro.2007.04.017.

Abstract

PURPOSE

The purpose of this study was to retrospectively evaluate clinical results after arthroscopic anterior cruciate ligament (ACL) reconstruction by use of hamstring autograft with femoral fixation via 2 bioabsorbable cross pins (Rigidfix system; DePuy Mitek, Raynham, MA).

METHODS

We evaluated the results of 117 knees (117 patients) that had been treated with arthroscopic ACL reconstruction by use of hamstring autograft with femoral fixation via 2 bioabsorbable cross pins from September 2001 to November 2002. The mean follow-up period was 26.9 months (range, 25 to 32 months). Patients were evaluated by the Lachman test, pivot-shift test, KT-2000 arthrometer (MEDmetric, San Diego, CA) test, Lysholm score, and International Knee Documentation Committee grade at the preoperative and follow-up examinations. Of the knees, 74 were assessed by second-look arthroscopy.

RESULTS

The mean Lysholm score was 72.6 (range, 51 to 86) preoperatively and 93.7 (range, 71 to 99) postoperatively. On the basis of the final International Knee Documentation Committee grade, 75 knees were normal (A), 36 were nearly normal (B), 6 were abnormal (C), and none were severely abnormal (D). KT-2000 arthrometer analysis revealed that 112 knees (95.7%) were grade A or B, with a median laxity of 1.3 mm (range, 1 to 6 mm) at final follow-up. Of the 74 knees that were assessed by second-look arthroscopy, 52 had preserved good tension, 22 had some laxity, and none had graft failure or rupture.

CONCLUSIONS

ACL reconstruction via 4-strand hamstring autograft with femoral fixation by use of 2 bioabsorbable cross pins eliminated anterior tibial translation in 93.1% of patients at a mean follow-up of 26.9 months. The bioabsorbable cross-pin femoral fixation method via hamstring tendon autograft can be effective, useful, and reproducible.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

本研究的目的是回顾性评估采用绳肌自体移植物并通过2枚生物可吸收交叉销钉(Rigidfix系统;DePuy Mitek公司,美国马萨诸塞州雷纳姆)进行股骨固定的关节镜下前交叉韧带(ACL)重建术后的临床结果。

方法

我们评估了2001年9月至2002年11月期间接受关节镜下ACL重建、采用绳肌自体移植物并通过2枚生物可吸收交叉销钉进行股骨固定治疗的117例膝关节(117例患者)的结果。平均随访期为26.9个月(范围为25至32个月)。在术前和随访检查时,通过Lachman试验、轴移试验、KT-2000关节测量仪(MEDmetric公司,美国加利福尼亚州圣地亚哥)检查、Lysholm评分和国际膝关节文献委员会分级对患者进行评估。其中74例膝关节接受了二次关节镜检查。

结果

术前平均Lysholm评分为72.6(范围为51至86),术后为93.7(范围为71至99)。根据最终的国际膝关节文献委员会分级,75例膝关节正常(A级),36例接近正常(B级),6例异常(C级),无严重异常(D级)。KT-2000关节测量仪分析显示,112例膝关节(95.7%)为A级或B级,末次随访时的中位松弛度为1.3毫米(范围为1至6毫米)。在接受二次关节镜检查的74例膝关节中,52例保持良好张力,22例有一定程度的松弛,无移植物失败或断裂。

结论

采用4股绳肌自体移植物并通过2枚生物可吸收交叉销钉进行股骨固定的ACL重建在平均随访26.9个月时使93.1%的患者消除了胫骨前移。通过绳肌腱自体移植物的生物可吸收交叉销钉股骨固定方法可能是有效、有用且可重复的。

证据水平

IV级,治疗性病例系列。

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