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与急性髌腱断裂相比,手术修复急性股四头肌腱断裂后膝关节功能更好。

Better knee function after surgical repair of acute quadriceps tendon rupture in comparison to acute patellar tendon rupture.

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessalia, Mezourlo, 41110 Larissa, Greece.

Department of Orthopedic Surgery, Sri Narayani hospital and research centre, Vellore, Tamil Nadu, India.

出版信息

Orthop Traumatol Surg Res. 2019 Feb;105(1):119-123. doi: 10.1016/j.otsr.2018.09.019. Epub 2018 Nov 16.

Abstract

INTRODUCTION

The purpose of this study was to determine if there is a difference in knee function between patients with quadriceps tendon rupture and patellar tendon rupture after acute surgical repair. Our hypothesis was that knee function would be similar between the two groups.

METHODS

The study population included 24 patients; 13 patients suffered from quadriceps tendon rupture and 11 patients from patellar tendon rupture. All patients underwent acute surgical repair using heavy non-absorbable trans-osseous sutures; another non-absorbable suture, passed through both retinaculum and around the repaired tendon to augment the repair. Clinical evaluation was performed using the Lysholm, Kujala, and VAS scoring systems. In addition, radiographic evaluation to evaluate patellar height and patello-femoral joint arthritis using Iwano's classification was performed.

RESULTS

The average follow-up time was 70.5 months. All patients in the quadriceps tendon group had full range of knee motion while 3 patients (27%) in the patellar tendon group had reduced knee flexion. Patients in the quadriceps tendon group had a significantly higher Kujala score in comparison to the patellar tendon group (88 vs. 73 p=0.033). No significant differences were identified between the two groups according to the Lysholm scoring system. Patients in the quadriceps tendon group had significantly less pain according to VAS scale (1.2 vs. 3.5 p=0.012). Radiographic evaluation revealed that two patients from each group showed signs of grade II patello-femoral joint arthritis according to Iwano's classification.

CONCLUSION

Acute surgical repair of quadriceps tendon ruptures provides better knee function, in comparison to the surgical restoration of patellar tendon rupture.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

摘要

引言

本研究旨在确定在急性手术修复后,股四头肌腱断裂和髌腱断裂患者的膝关节功能是否存在差异。我们的假设是两组患者的膝关节功能相似。

方法

研究人群包括 24 名患者;13 名患者患有股四头肌腱断裂,11 名患者患有髌腱断裂。所有患者均接受急性手术修复,使用重非吸收性经骨缝线;另一种非吸收性缝线穿过支持带并环绕修复的肌腱以增强修复。使用 Lysholm、Kujala 和 VAS 评分系统进行临床评估。此外,还进行了放射学评估,使用 Iwano 分类评估髌股关节关节炎和髌腱高度。

结果

平均随访时间为 70.5 个月。股四头肌腱组所有患者膝关节活动度均完全恢复,而髌腱组 3 名患者(27%)膝关节屈曲受限。股四头肌腱组的 Kujala 评分明显高于髌腱组(88 对 73,p=0.033)。根据 Lysholm 评分系统,两组之间无显著差异。股四头肌腱组患者的 VAS 评分明显较低(1.2 对 3.5,p=0.012)。放射学评估显示,每组有 2 名患者根据 Iwano 分类显示出 II 级髌股关节关节炎迹象。

结论

与髌腱断裂的手术修复相比,急性手术修复股四头肌腱断裂可提供更好的膝关节功能。

证据水平

III 级,回顾性比较研究。

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