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单束前交叉韧带重建的临床及关节镜检查结果:残余保留技术与传统技术的比较

Clinical and arthroscopic outcome of single bundle anterior cruciate ligament reconstruction: Comparison of remnant preservation versus conventional technique.

作者信息

Choi Sungwook, Kim Myung-Ku, Kwon Yong Suk, Kang Hyunseong

机构信息

Department of Orthopaedic Surgery, Jeju National University School of Medicine, Jeju, South Korea.

Department of Orthopaedic Surgery, Inha University School of Medicine, Incheon, South Korea.

出版信息

Knee. 2017 Oct;24(5):1025-1032. doi: 10.1016/j.knee.2017.05.012. Epub 2017 Aug 14.

Abstract

BACKGROUND

The purpose of this study was to compare the clinical outcomes and second-look arthroscopic findings of remnant preservation technique with those of conventional anterior cruciate ligament (ACL) reconstruction in single bundle ACL reconstructions.

METHODS

One hundred sixty two consecutive patients underwent ACL reconstruction by one surgeon, with 93 patients receiving remnant preservation technique (Group A) and 69 patients receiving conventional ACL reconstruction (Group B). The mean follow-up was 15months. Clinical outcomes were assessed using Lysholm scores and the International Knee Documentation Committee form (IKDC form) evaluation. Post-operative knee stability was evaluated through manual knee laxity evaluation, pivot-shift test, and a Telos device.

RESULTS

Differences in post-operative stability (manual knee laxity, pivot shift test and Telos device) were not significant between the groups (p=0.681, p=0.610, p=0.696). And also no significant differences were noted with respect to the IKDC form and the latest Lysholm scores. But in the second-look arthroscopic findings, synovial coverage was confirmed to be excellent in 36% (22/61) of Group A patients and 23% (7/30) of Group B patients.

CONCLUSIONS

ACL reconstruction with both techniques was found to result in acceptable stability, clinical outcomes and second-look arthroscopic findings. With regard to synovial coverage, the remnant reservation techniques were found to be superior to conventional ACL reconstruction.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

摘要

背景

本研究旨在比较单束前交叉韧带(ACL)重建中保留残端技术与传统ACL重建的临床疗效及二次关节镜检查结果。

方法

162例连续患者由同一位外科医生进行ACL重建,其中93例患者接受保留残端技术(A组),69例患者接受传统ACL重建(B组)。平均随访时间为15个月。采用Lysholm评分和国际膝关节文献委员会表格(IKDC表格)评估临床疗效。通过手动膝关节松弛度评估、轴移试验和Telos装置评估术后膝关节稳定性。

结果

两组之间术后稳定性(手动膝关节松弛度、轴移试验和Telos装置)差异无统计学意义(p = 0.681,p = 0.610,p = 0.696)。IKDC表格和最新的Lysholm评分也无显著差异。但在二次关节镜检查结果中,A组36%(22/61)的患者和B组23%(7/30)的患者滑膜覆盖情况良好。

结论

两种技术的ACL重建均能获得可接受的稳定性、临床疗效和二次关节镜检查结果。在滑膜覆盖方面,保留残端技术优于传统ACL重建。

证据水平

III级,回顾性比较研究。

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