Wu Qipeng, Yu Tao, Lei Bo, Huang Wenjie, Huang Ruokun
Department of Orthopedics, Wuhan Fourth Hospital, Puai Hospital,Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).
Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Med Sci Monit. 2020 Mar 5;26:e922925. doi: 10.12659/MSM.922925.
BACKGROUND Anatomical reconstruction using a semitendinosus tendon autograft is one of the most widely-used techniques for chronic lateral ankle instability (CLAI), and it can result in good biomechanical recovery for patients. The purpose of this study was to investigate the outcome of a novel individualized three-dimensional printed guide template for lateral ankle ligament reconstruction compared with the traditional surgical methods. MATERIAL AND METHODS We retrospectively studied 34 patients with CLAI who required lateral ankle ligament reconstruction. Patients were randomly divided into 2 cohorts: the template group (18 patients) and the conventional group (16 patients). The average operation duration and number of radiation exposures were compared between the 2 cohorts. The displacement of anterior talar and talar tilt angle were recorded at the last follow-up, and Karlsson-Peterson score and American Orthopedic Foot and Ankle Society Score (AOFAS) were also compared. RESULTS All patients had satisfactory ankle stability at the last follow-up. The average operation duration was 51.9±3.6 min and the average number of radiation exposures was 1.34±0.6 in the template group, and the average operation duration was 72.4±12.6 min and the average number of radiation exposures was 6.58±1.7 in the conventional group. Difference between the 2 cohorts was statistically significant. However, in AOFAS (95.2±2.5 vs. 94.9±2.2; P>0.01.) and Karlsson Score (94.7±3.6 vs. 93.8±4.1; P>0.01.), no significant differences were found between the 2 cohorts. CONCLUSIONS Both the template technique and the conventional method provided satisfactory outcomes for CLAI patients. However, the shorter operation duration and low number of radiation exposures in the template cohort suggest it is the better alternative for treatment of CLAI.
使用半腱肌腱自体移植进行解剖重建是慢性外侧踝关节不稳(CLAI)最常用的技术之一,它能为患者带来良好的生物力学恢复。本研究的目的是探讨一种新型个体化三维打印引导模板用于外侧踝关节韧带重建与传统手术方法相比的效果。
我们回顾性研究了34例需要进行外侧踝关节韧带重建的CLAI患者。患者被随机分为两组:模板组(18例患者)和传统组(16例患者)。比较两组患者的平均手术时间和X线照射次数。在末次随访时记录距骨前移和距骨倾斜角的位移,并比较Karlsson-Peterson评分和美国矫形足踝协会评分(AOFAS)。
所有患者在末次随访时踝关节稳定性均令人满意。模板组平均手术时间为51.9±3.6分钟,平均X线照射次数为1.34±0.6次;传统组平均手术时间为72.4±12.6分钟,平均X线照射次数为6.58±1.7次。两组之间的差异具有统计学意义。然而,在AOFAS评分(95.2±2.5对94.9±2.2;P>0.01)和Karlsson评分(94.7±3.6对93.8±4.1;P>0.01)方面,两组之间未发现显著差异。
模板技术和传统方法对CLAI患者均提供了满意的治疗效果。然而,模板组较短的手术时间和较少的X线照射次数表明它是治疗CLAI的更好选择。