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动力性前抽屉支具治疗急性单纯后交叉韧带损伤:初步报告

Acute isolated injury of the posterior cruciate ligament treated by a dynamic anterior drawer brace: a preliminary report.

作者信息

Jacobi M, Reischl N, Wahl P, Gautier E, Jakob R P

机构信息

Department of Orthopaedic Surgery, HFR Fribourg Hôpital Cantonal, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland.

出版信息

J Bone Joint Surg Br. 2010 Oct;92(10):1381-4. doi: 10.1302/0301-620X.92B10.24807.

Abstract

We investigated the role of a functional brace worn for four months in the treatment of patients with an acute isolated tear of the posterior cruciate ligament to determine whether reduction of the posterior tibial translation during the healing period would give an improved final position of the tibia. The initial and follow-up stability was tested by Rolimeter arthrometry and radiography. The clinical outcome was evaluated using the Lysholm score, the Tegner score and the International Knee Documentation Committee scoring system at follow-up at one and two years. In all, 21 patients were studied, 21 of whom had completed one-year and 17 a two-year follow-up. The initial mean posterior sag (Rolimeter measurement) of 7.1 mm (5 to 10) was significantly reduced after 12 months to a mean of 2.3 mm (0 to 6, p < 0.001) and to a mean of 3.2 mm (2 to 7, p = 0.001) after 24 months. Radiological measurement gave similar results. The mean pre-injury Lysholm score was normal at 98 (95 to 100). At follow-up, a slight decrease in the mean values was observed to 94.0 (79 to 100, p = 0.001) at one year and 94.0 (88 to 100, p = 0.027, at two years). We concluded that the posterior cruciate ligament has an intrinsic healing capacity and, if the posteriorly translated tibia is reduced to a physiological position, it can heal with less attentuation. The applied treatment produces a good to excellent functional result.

摘要

我们研究了佩戴功能性支具四个月对急性孤立性后交叉韧带撕裂患者的治疗作用,以确定在愈合期减少胫骨后移是否能使胫骨最终位置得到改善。通过Rolimeter关节测量仪和X线摄影对初始及随访时的稳定性进行测试。在随访1年和2年时,使用Lysholm评分、Tegner评分和国际膝关节文献委员会评分系统评估临床结果。总共对21例患者进行了研究,其中21例完成了1年随访,17例完成了2年随访。初始时平均后移(Rolimeter测量)为7.1 mm(5至10),12个月后显著降至平均2.3 mm(0至6,p<0.001),24个月后降至平均3.2 mm(2至7,p = 0.001)。放射学测量结果相似。损伤前Lysholm评分均值正常,为98(95至100)。随访时,1年时均值略有下降至94.0(79至100,p = 0.001),2年时为94.0(88至100,p = 0.027)。我们得出结论,后交叉韧带具有内在愈合能力,并且如果后移的胫骨恢复到生理位置,它可以在较少衰减的情况下愈合。所应用的治疗产生了良好至优异的功能结果。

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