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双束与解剖单束前交叉韧带重建术后2年的体内膝关节旋转稳定性

In vivo knee rotational stability 2 years after double-bundle and anatomic single-bundle ACL reconstruction.

作者信息

Komzák M, Hart R, Feranec M, Šmíd P, Kocová R

机构信息

, MUDr.Jana Jánského 11, 669 02, Znojmo, Czech Republic.

出版信息

Eur J Trauma Emerg Surg. 2018 Feb;44(1):105-111. doi: 10.1007/s00068-017-0769-7. Epub 2017 Mar 2.

Abstract

PURPOSE

The objective of this study was to evaluate knee rotational stability at least 2 years after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction (SB) and double-bundle ACL reconstruction (DB) in comparison with the contralateral healthy knee joint. The Cincinnati, Lysholm and IKDC scores were analysed too.

METHODS

There were 40 patients in both groups, the mean follow-up was 27 months. For all measurements, the navigation system OrthoPilot was used. Measurement started with the patient in the standing position in neutral rotation. Then, the patient achieved in 30° knee flexion under weight-bearing maximal external trunk rotation and returned to the neutral position. The same measurement was done for the internal trunk rotation. For the anterior-posterior stability, KT-1000 arthrometer was used. All measurements were repeated three times for each knee joint.

RESULTS

After the DB reconstruction, the mean external rotation of the tibia (ER) was 8.2° and the internal rotation (IR) was 10.2°. In the contralateral healthy knee joint, ER was 8.5° (p = 0.597) and IR was 12.1° (p = 0.064). After the SB reconstruction, ER was 9.4° and IR was 13.1°. In the contralateral healthy knee joint, ER was 7.7° (p = 0.066) and IR was 9.8° (p = 0.005). Anterior-posterior translation was to the same extent for both groups.

CONCLUSIONS

The DB reconstruction of the ACL restores the rotational stability of the knee joint without any significant difference in comparison to the contralateral healthy knee (p > 0.05). The main finding of this study is that the internal rotational stability of the knee joint after the anatomic SB technique is not sufficient.

摘要

目的

本研究的目的是评估解剖单束前交叉韧带(ACL)重建(SB)和双束ACL重建(DB)至少2年后膝关节的旋转稳定性,并与对侧健康膝关节进行比较。同时分析了辛辛那提、莱霍尔姆和IKDC评分。

方法

两组各有40例患者,平均随访27个月。所有测量均使用导航系统OrthoPilot。测量从患者中立旋转站立位开始。然后,患者在负重下膝关节屈曲30°时实现最大躯干外旋并回到中立位。对内旋进行相同测量。对于前后稳定性,使用KT-1000关节测量仪。每个膝关节的所有测量均重复三次。

结果

DB重建后,胫骨平均外旋(ER)为8.2°,内旋(IR)为10.2°。在对侧健康膝关节中,ER为8.5°(p = 0.597),IR为12.1°(p = 0.064)。SB重建后,ER为9.4°,IR为13.1°。在对侧健康膝关节中,ER为7.7°(p = 0.066),IR为9.8°(p = 0.005)。两组的前后平移程度相同。

结论

ACL的DB重建恢复了膝关节的旋转稳定性,与对侧健康膝关节相比无显著差异(p > 0.05)。本研究的主要发现是解剖SB技术后膝关节的内旋稳定性不足。

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