Kim Sung-Jae, Shim Dong-Woo, Park Kwang-Won
Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Knee Surg Relat Res. 2012 Sep;24(3):173-9. doi: 10.5792/ksrr.2012.24.3.173. Epub 2012 Sep 3.
In anterior cruciate ligament (ACL) injury, conventional adult reconstruction techniques have to face the potential risk of growth disturbance or angular deformities in skeletally immature patients. The aim of this study was to evaluate the clinical outcomes of ACL reconstruction by conventional transphyseal tunnel technique.
On a retrospective basis, we reviewed 25 skeletally immature patients; all the patients showed skeletal maturity at last follow-up, and the mean age was 16.4 years. The average injury to surgery interval was 12.6 months. Clinical outcomes were assessed at a mean of 74.4 months postoperatively using the Lysholm Knee Scoring Scale, the Tegner activity level, the International Knee Documentation Committee (IKDC), and plain radiographs.
All the patients had undergone transphyseal reconstruction of ACL. The mean Lysholm score was 48.36 points preoperatively and 93.32 points postoperatively; the mean Tegner activity level was changed from 3.0 points to 5.6 points. The mean IKDC level was categorized as C preoperatively and changed to A postoperatively.
Our midterm outcome at an average 6 years after surgery was satisfactory without significant leg length discrepancies or abnormal alignment of the knee joint. Transphyseal reconstruction of ACL is a good treatment modality in the skeletally immature patient.
在前交叉韧带(ACL)损伤中,传统的成人重建技术在骨骼未成熟患者中面临生长发育障碍或角畸形的潜在风险。本研究的目的是评估传统经骨骺隧道技术进行ACL重建的临床结果。
我们回顾性分析了25例骨骼未成熟患者;所有患者在最后一次随访时均显示骨骼成熟,平均年龄为16.4岁。受伤至手术的平均间隔时间为12.6个月。术后平均74.4个月时,使用Lysholm膝关节评分量表、Tegner活动水平、国际膝关节文献委员会(IKDC)和X线平片评估临床结果。
所有患者均接受了ACL的经骨骺重建。术前Lysholm评分平均为48.36分,术后为93.32分;Tegner活动水平平均从3.0分提高到5.6分。术前IKDC水平平均分类为C级,术后变为A级。
我们术后平均6年的中期结果令人满意,没有明显的腿长差异或膝关节异常对线。ACL的经骨骺重建是骨骼未成熟患者的一种良好治疗方式。