Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England.
J Bone Joint Surg Am. 2013 Sep 4;95(17):e1231-6. doi: 10.2106/JBJS.L.01462.
Patellar tendon reconstruction is technically demanding and is indicated in patients with chronic ruptures (i.e., still present more than six weeks after injury). The purpose of this study was to assess the effectiveness of this procedure in patients with impaired function following patellar tendon rupture.
Nineteen patients underwent autologous ipsilateral hamstring tendon graft reconstruction for management of a chronic patellar tendon rupture. The clinical diagnosis was supported by imaging radiographs and magnetic resonance imaging. The modified Cincinnati rating system questionnaire and the Kujala scoring questionnaire were administered preoperatively and at the last examination, an average follow-up of 5.8 years (range, four to 7.8 years) postoperatively. Thigh volume, cross-sectional area of the thigh (muscle and bone), and the maximum isometric voluntary contraction strength of the extensor apparatus of the knee were measured bilaterally in all nineteen patients.
At the last follow-up visit, knee flexion had increased from a mean of 110° preoperatively to a mean of 132° and extension lag had significantly decreased from 20° preoperatively to 3°; the mean modified Cincinnati and Kujala scores were notably improved. All patients had returned to ordinary daily activities. Fourteen of nineteen patients were very satisfied with the procedure, three were satisfied, one was moderately satisfied, and one was unsatisfied.
On the basis of our review of nineteen patients, hamstring tendon reconstruction of chronic patellar tendon rupture provided good functional recovery and return to preinjury daily activities.
髌腱重建术技术要求较高,适用于慢性撕裂(即受伤后仍存在超过六周)的患者。本研究旨在评估该手术对髌腱撕裂后功能受损患者的疗效。
19 例患者采用自体同侧腘绳肌腱重建术治疗慢性髌腱撕裂。临床诊断通过影像学 X 线片和磁共振成像得到支持。术前和末次随访时(平均随访 5.8 年,范围 4 至 7.8 年)使用改良辛辛那提评分系统问卷和 Kujala 评分问卷进行评估。对所有 19 例患者均进行双侧大腿体积、大腿横截面积(肌肉和骨骼)以及膝关节伸肌装置的最大等长自愿收缩力测量。
末次随访时,膝关节屈曲从术前平均 110°增加到 132°,且伸展滞后明显从术前的 20°减少到 3°;改良辛辛那提和 Kujala 评分明显改善。所有患者均已恢复日常活动。19 例患者中有 14 例非常满意手术,3 例满意,1 例满意,1 例不满意。
基于对 19 例患者的回顾,腘绳肌腱重建慢性髌腱撕裂可获得良好的功能恢复和重返术前日常活动能力。