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关节镜辅助下前后交叉韧带联合重建

[Arthroscopically-assisted combined anterior and posterior cruciate ligament reconstruction].

作者信息

Schofer M D, Peterlein C D, Fuchs-Winkelmann S, Kortmann H R

机构信息

Klinik für Orthopädie und Rheumatologie, Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg, Baldingerstrasse, 35033 Marburg, Deutschland.

出版信息

Unfallchirurg. 2008 Sep;111(9):703-10. doi: 10.1007/s00113-008-1468-y.

Abstract

BACKGROUND

The best treatment of a combined rupture of the anterior and posterior cruciate ligaments is still unclear.

METHODS

Nine patients with unilateral traumatic ruptures of both the anterior and posterior cruciate ligaments were treated by arthroscopically-assisted simultaneous reconstruction. The operation was done using hamstring tendon and patellar tendon autografts, an average of 235 days (range 52-567) after the initial trauma. Patients were followed up for an average of 37 months (range 24-58) after surgery. For this retrospective cohort study, we used the Lysholm knee score, the Tegner activity score, and the SF-36 questionnaire as a means of assessment.

RESULTS

The evaluation at follow-up showed an average score of 74 points on the Lysholm scale. Using the IKDC evaluation, four patients could be placed in group B and five patients in group C. A significant increase, from 1.9 points before trauma to 5.0 points at follow-up, was observed on the Tegner activity score. Comparing the operated with the healthy knees, with respect to stability and isokinetic muscle strength, we noted significantly better scores in the healthy knees. Using the SF-36 questionnaire, patients showed a reduced level of physical well-being.

CONCLUSION

The treated patients were able to carry out their activities of everyday life. However, none of them returned to their preinjury activity level.

摘要

背景

前交叉韧带和后交叉韧带联合断裂的最佳治疗方法仍不明确。

方法

9例单侧前交叉韧带和后交叉韧带创伤性断裂患者接受关节镜辅助下同期重建治疗。手术采用腘绳肌腱和髌腱自体移植物,在初次创伤后平均235天(范围52 - 567天)进行。术后患者平均随访37个月(范围24 - 58个月)。对于这项回顾性队列研究,我们使用Lysholm膝关节评分、Tegner活动评分和SF - 36问卷作为评估手段。

结果

随访评估显示Lysholm量表平均得分为74分。采用IKDC评估,4例患者可归为B组,5例患者归为C组。Tegner活动评分从创伤前的1.9分显著提高到随访时的5.0分。将手术侧膝关节与健侧膝关节在稳定性和等速肌力方面进行比较,我们发现健侧膝关节的评分明显更高。使用SF - 36问卷时,患者的身体健康水平有所下降。

结论

接受治疗的患者能够进行日常生活活动。然而,他们中没有人恢复到受伤前的活动水平。

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