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保留残端的单束后交叉韧带重建:外侧与内侧增强技术。

Single-bundle posterior cruciate ligament reconstruction with remnant preservation: lateral versus medial-sided augmentation technique.

机构信息

Department of Arthroscopic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.

出版信息

Orthop Surg. 2009 Feb;1(1):66-73. doi: 10.1111/j.1757-7861.2008.00012.x.

Abstract

OBJECTIVE

To compare the results of lateral versus medial-sided augmentation techniques in single-bundle posterior cruciate ligament (PCL) reconstruction with remnant preservation.

METHODS

Forty-two cases of isolated chronic PCL ruptures were reconstructed in a single-bundle manner with remnant preservation. The patients were randomly separated into two groups: in the medial-sided augmentation (MSA) group the graft passed through the medial side of the remnant and in the lateral-sided augmentation (LSA) group it passed through the lateral side.

RESULTS

Nineteen patients in the MSA group and 17 in the LSA group were followed up for a minimum of 2 years. At the final follow-up, the average side-to-side differences in posterior laxity were 1.6 ± 1.2 mm and 1.5 ± 1.3 mm respectively in the MSA and LSA groups. According to the International Knee Documentation Committee (IKDC) scale, patient numbers graded as normal, nearly normal and abnormal were 14 (73.7%), 4 (21.1%), and 1 (5.3%) in the MSA group, and 13 (76.5%), 3 (17.6%), and 1 (5.9%) in the LSA group. The IKDC subjective scores were 93.1 ± 3.8 and 92.6 ± 4.1, the Lysholm scores were 95.0 ± 4.6 and 93.7 ± 4.2, and the Tegner scores were 5.4 ± 0.9 and 5.6 ± 0.7 respectively in the MSA and LSA groups. Statistical analysis showed no significant differences between the MSA and the LSA group regarding all subjective and objective results.

CONCLUSION

In single-bundle PCL reconstruction with remnant preservation, similar subjective and objective results can be obtained with MSA and LSA techniques.

摘要

目的

比较保留残端的单束后交叉韧带(PCL)重建中,外侧与内侧增强技术的结果。

方法

42 例孤立性慢性 PCL 撕裂患者采用保留残端的单束方式进行重建。患者随机分为两组:内侧增强(MSA)组的移植物穿过残端的内侧,外侧增强(LSA)组的移植物穿过残端的外侧。

结果

MSA 组 19 例,LSA 组 17 例患者随访至少 2 年。末次随访时,MSA 组和 LSA 组的后向松弛侧间差异平均分别为 1.6±1.2mm 和 1.5±1.3mm。根据国际膝关节文献委员会(IKDC)评分,MSA 组正常、接近正常和异常的患者分别为 14 例(73.7%)、4 例(21.1%)和 1 例(5.3%),LSA 组分别为 13 例(76.5%)、3 例(17.6%)和 1 例(5.9%)。MSA 组和 LSA 组的 IKDC 主观评分分别为 93.1±3.8 和 92.6±4.1,Lysholm 评分分别为 95.0±4.6 和 93.7±4.2,Tegner 评分分别为 5.4±0.9 和 5.6±0.7。MSA 和 LSA 组在所有主观和客观结果方面均无统计学差异。

结论

在保留残端的单束 PCL 重建中,MSA 和 LSA 技术可获得相似的主观和客观结果。

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