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一项评估关节镜下单束与双束前交叉韧带重建的临床影像学结果的前瞻性研究。

A prospective study to evaluate the clinico-radiological outcomes of arthroscopic single bundle versus double bundle anterior cruciate ligament reconstruction.

作者信息

Devgan Ashish, Rohilla Rajesh, Singh Amanpreet, Tanwar Milind, Devgan Radhika, Siwach Karan

机构信息

Department of Orthopaedics, PGIMS, Rohtak, Haryana, India.

GMERS Medical College, Sola, Ahmedabad, India.

出版信息

J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):236-242. doi: 10.1016/j.jcot.2016.01.004. Epub 2016 Feb 13.

Abstract

INTRODUCTION

The aim of the study was to compare clinical and radiological outcomes of arthroscopic single-bundle versus double-bundle anterior cruciate ligament (ACL) reconstruction.

PATIENT AND METHODS

60 patients with isolated ACL injury were divided into single bundle (SB) ( = 30) and double bundle (DB) reconstruction groups ( = 30) and operated between July 2009 and July 2012. Outcome evaluation was performed using GNRB arthrometer, International Knee Documentation Committee & Lysholm scale. Rotational stability was determined by lateral pivot-shift test. Magnetic resonance imaging (MRI) was performed postoperatively to compare the reconstructed ACL graft orientation.

RESULTS

Average follow-up was 34.8 months in SB and 36.2 months in DB group. At final follow-up, mean Lysholm score was 94.13 ± 2.67 in SB and 93.13 ± 3.31 in DB group ( value = 0.202, statistically non-significant). All patients in both groups were in grade A or B according to objective IKDC scores. Mean differential anterior tibial translation was 1.45 ± 0.6 mm in SB and 1.17 ± 0.8 mm in DB group ( value = 0.105, NS). All had negative pivot shift test in DB group while 2 patients had positive pivot shift in SB group. MRI of operated knees showed that values of mean sagittal ACL graft-tibial angle and mean coronal ACL graft-tibial angle were comparable in both groups ( value > 0.05, NS).

CONCLUSIONS

There was no statistically significant difference concerning knee stability, knee scores, subjective evaluations, and MRI evaluation of graft inclination angles between single- and double-bundle ACL reconstruction groups at an average of 35 months of follow-up.

摘要

引言

本研究旨在比较关节镜下单束与双束前交叉韧带(ACL)重建的临床和影像学结果。

患者与方法

60例单纯ACL损伤患者被分为单束(SB)组(n = 30)和双束(DB)重建组(n = 30),于2009年7月至2012年7月期间接受手术。使用GNRB关节测量仪、国际膝关节文献委员会(IKDC)及Lysholm量表进行结果评估。通过外侧轴移试验确定旋转稳定性。术后进行磁共振成像(MRI)以比较重建的ACL移植物方向。

结果

SB组平均随访34.8个月,DB组平均随访36.2个月。在末次随访时,SB组Lysholm评分均值为94.13±2.67,DB组为93.13±3.31(P值 = 0.202,无统计学意义)。根据客观IKDC评分,两组所有患者均为A级或B级。SB组平均胫骨前移差值为1.45±0.6 mm,DB组为1.17±0.8 mm(P值 = 0.105,无统计学意义)。DB组所有患者轴移试验均为阴性,而SB组有2例患者轴移试验为阳性。手术膝关节的MRI显示,两组间平均矢状面ACL移植物 - 胫骨角和平均冠状面ACL移植物 - 胫骨角的值具有可比性(P值>0.05,无统计学意义)。

结论

在平均35个月的随访中,单束与双束ACL重建组在膝关节稳定性、膝关节评分、主观评估以及移植物倾斜角度的MRI评估方面均无统计学显著差异。

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