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全膝关节置换术中内侧副韧带损伤的结局

Outcomes of Medial Collateral Ligament Injuries during Total Knee Arthroplasty.

作者信息

Siqueira Marcelo B P, Haller Kathryn, Mulder Andrew, Goldblum Andrew S, Klika Alison K, Barsoum Wael K

机构信息

Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio.

出版信息

J Knee Surg. 2016 Jan;29(1):68-73. doi: 10.1055/s-0034-1394166. Epub 2014 Oct 16.

Abstract

Intraoperative medial collateral ligament (MCL) disruption during total knee arthroplasty (TKA) is often managed with either primary repair or use of a constrained implant. A total of 23 patients with an MCL injury during TKA between 2003 and 2009 were compared with 92 matched controls. Of the 23 patients, 10 were treated with an unconstrained implant and primary MCL repair, 8 with constrained implants, 3 with constrained implants and MCL repair, and 2 with unconstrained implants and no MCL repair. After an average 5-year follow-up, patients had lower Knee Society Scores (KSS), 79 versus 87 (p = 0.03), but similar Knee Function Scores (KFS), 68 versus 72 (p = 0.35). The improvement between preoperative and postoperative KSS and KFS did not vary among the two groups (p = 0.88 and p = 0.77, respectively). Postoperative scores did not vary significantly among the four treatment modalities. Conservative treatment can provide satisfactory outcomes and avoid potential complications of increased constraint.

摘要

全膝关节置换术(TKA)术中内侧副韧带(MCL)断裂通常采用一期修复或使用限制性假体进行处理。对2003年至2009年间在TKA术中发生MCL损伤的23例患者与92例匹配的对照患者进行了比较。在这23例患者中,10例采用非限制性假体和MCL一期修复治疗,8例采用限制性假体治疗,3例采用限制性假体和MCL修复治疗,2例采用非限制性假体且未进行MCL修复。经过平均5年的随访,患者的膝关节协会评分(KSS)较低,分别为79分和87分(p = 0.03),但膝关节功能评分(KFS)相似,分别为68分和72分(p = 0.35)。两组患者术前和术后KSS及KFS的改善情况无差异(分别为p = 0.88和p = 0.77)。四种治疗方式术后评分无显著差异。保守治疗可提供满意的结果,并避免增加限制性带来的潜在并发症。

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