Cheng Cong, Ren Shiyou, Chen Peng, Jiang Changqing, Zhang Wentao
Clinical College, Anhui Medical University & Peking University Shenzhen Hospital, Shenzhen Guangdong, 518036, P. R. China.
Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 May 8;30(5):558-561. doi: 10.7507/1002-1892.20160113.
To explore the relationship between anterior cruciate ligament (ACL) reconstruction failure and medial meniscus injury and decide whether medial meniscus injury could be the judgment index for ACL reconstruction failure without trauma history.
Between March 2011 and December 2015, 117 patients underwent ACL reconstruction, and the clinical data were analyzed retrospectively. All patients had no trauma history after ACL resconstruction. MRI examination showed medial meniscus injury in 56 cases (observation group) and no medial meniscus injury in 61 cases (control group). There was no significant difference in gender, age, side, reconstructive surgery, and follow-up time between 2 groups (>0.05). The KT-2000 arthrometer was used to measure the difference value of tibial anterior displacement between two knees in 30° knee flexion. Then wether the ACL reconsruction failure was judged according to the evaluation criteria proposed by Rijke et al.
In observation group, the difference value of tibial anterior displacement was <3 mm in 7 patients, 3-5 mm in 11 patients, and >5 mm in 38 patients. In control group, the difference value of tibial anterior displacement was <3 mm in 31 patients, 3-5 mm in 18 patients, and >5 mm in 12 patients. The ACL reconstruction failure rate of observation group (67.9%) was significantly higher than that of control group (19.7%) (χ=27.700, =0.000).
After ACL reconstruction, medial meniscus injury occurs under no trauma history circumstances, indicating ACL reconstruction failure.
探讨前交叉韧带(ACL)重建失败与内侧半月板损伤之间的关系,并确定内侧半月板损伤是否可作为无创伤史的ACL重建失败的判断指标。
回顾性分析2011年3月至2015年12月期间117例行ACL重建患者的临床资料。所有患者在ACL重建后均无创伤史。MRI检查显示内侧半月板损伤56例(观察组),无内侧半月板损伤61例(对照组)。两组患者在性别、年龄、患侧、重建手术及随访时间方面差异均无统计学意义(>0.05)。采用KT-2000关节测量仪测量屈膝30°时双膝关节胫骨前移差值。然后根据Rijke等人提出的评估标准判断ACL重建是否失败。
观察组中,胫骨前移差值<3 mm者7例,35 mm者11例,>5 mm者38例。对照组中,胫骨前移差值<3 mm者31例,35 mm者18例,>5 mm者12例。观察组ACL重建失败率(67.9%)显著高于对照组(19.7%)(χ=27.700,=0.000)。
ACL重建后,在无创伤史情况下发生内侧半月板损伤,提示ACL重建失败。