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关节镜下全关节内后交叉韧带与腘肌腱重建术对比腘腓韧带重建术:至少2年随访的临床结果

[Arthroscopic all-inside reconstruction for posterior cruciate ligament and popliteus tendon compared with popliteofibular ligament reconstruction: clinical outcome of minimum 2-year follow-up].

作者信息

Zhang H, Liu X, Hong L, Geng X S, Feng H

机构信息

Sports Medicine Service, Beijing Jishuitan Hospital, Beijing 100035, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Apr 18;48(2):237-43.

Abstract

OBJECTIVE

To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction, compared with an open popliteofibular ligament reconstruction.

METHODS

Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament. The patients were assessed for knee instability with use of the dial test at 30° and 90°, together with posterior stress radiography and KT-1000 measurement.

RESULTS

The mean time of follow-up was more than 2 years. At the final follow-up evaluation, the tibial posterior translation as measured by stress radiography at 90° of knee flexion, the anterior-posterior translation as measured by KT-1000, and the external rotation of tibia as measured by dial test were reduced postoperatively (P<0.001) in both groups. Between the two groups, the preoperative tibial posterior translation as measured by stress radiography and the preoperative mean anterior-posterior translation as measured by KT-1000 in the popliteofibular ligament group were a little more than those in the popliteus tendon group (P=0.014, P<0.001). But the other comparisons were not significantly different (P>0.05). The final flexion losses were 3.33°±4.88° and 3.06°±3.38° for the two groups.

CONCLUSION

Combined with posterior cruciate ligament reconstruction, anatomical posterolateral corner reconstruction of the popliteus tendon and open reconstruction of popliteofibular ligament showed similar outcomes. This study demonstrated that both posterolateral corner reconstruction techniques were a reliable alternative method in addressing posterolateral corner and posterior cruciate ligament insufficiency of the knee.

摘要

目的

描述一期手术进行后交叉韧带重建及腘肌腱重建的后外侧角重建与开放腘腓韧带重建相比的临床结果。

方法

我们的研究纳入了33例患者,这些患者采用跟腱-骨同种异体移植进行后交叉韧带重建,并通过关节镜下腘肌腱解剖重建或开放腘腓韧带重建进行后外侧角重建。使用30°和90°的表盘试验、后应力放射摄影和KT-1000测量对患者的膝关节不稳定情况进行评估。

结果

平均随访时间超过2年。在末次随访评估时,两组患者在膝关节屈曲90°时通过应力放射摄影测量的胫骨后移、通过KT-1000测量的前后移位以及通过表盘试验测量的胫骨外旋在术后均有所减少(P<0.001)。两组之间,腘腓韧带组通过应力放射摄影测量的术前胫骨后移以及通过KT-1000测量的术前平均前后移位比腘肌腱组略多(P=0.014,P<0.001)。但其他比较无显著差异(P>0.05)。两组的最终屈曲丢失分别为3.33°±4.88°和3.06°±3.38°。

结论

结合后交叉韧带重建,腘肌腱解剖后外侧角重建和腘腓韧带开放重建显示出相似的结果。本研究表明,两种后外侧角重建技术都是解决膝关节后外侧角和后交叉韧带功能不全的可靠替代方法。

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