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自体腘绳肌腱单束解剖重建前交叉韧带的临床及功能预后的前瞻性评估

A prospective evaluation of clinical and functional outcome of single bundle anatomic anterior cruciate ligament reconstruction with hamstrings autograft.

作者信息

Shaikh Saeed Ahmed, Ahmed Naveed, Adil Salman, Jamali Allah Rakhio

机构信息

Department of Orthopedics, Jinnah Post Graduate Medical Center, Karachi, Pakistan.

Aga Khan University Hospital, Karachi, Pakistan.

出版信息

J Pak Med Assoc. 2020 Dec;70(12(B)):2476-2480. doi: 10.47391/JPMA.678.

Abstract

A case series was conducted at the Department of Orthopaedic surgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2016 to June 2018, to evaluate the functional and clinical outcome of arthroscopic anatomic anterior cruciate ligament (ACL) reconstruction with hamstrings autograft. Patients aged 17 years and above with anterior cruciate ligament (ACL) injuries of duration three months or older, diagnosed on history and clinical examination and confirmed on Magnetic Resonance Imaging were prospectively recruited from outpatient department. Patients with multiligamentous injury were excluded. Information on patient's demographics such as age, duration of injury and mechanism of injury were recorded. In addition, graft length and diameter, associated injuries of lateral or medical menisci were noted peroperatively. Patients were followed for a minimum of 12 months. The functional outcomes were assessed through lysholm knee score, and Tegner activity scale. Clinical outcome was assessed with loss of motion in flexion and extension and residual laxity using Lachman test. Paired sample t-test was applied to compare mean scores pre and post-operatively. The study findings reveal that arthroscopic anatomic Anterior Cruciate Ligament reconstruction using quadruple strand hamstring tendon autograft was an effective method of treatment for the ACL-deficient knee with improved clinical and functional status.

摘要

2016年7月至2018年6月,在卡拉奇真纳研究生医学中心骨科开展了一项病例系列研究,以评估关节镜下采用自体腘绳肌腱进行解剖学前交叉韧带(ACL)重建的功能和临床结果。年龄在17岁及以上、前交叉韧带(ACL)损伤持续时间达三个月或更长时间、经病史和临床检查诊断并经磁共振成像确认的患者,从门诊部前瞻性招募。多韧带损伤患者被排除。记录患者的人口统计学信息,如年龄、损伤持续时间和损伤机制。此外,术中记录移植物的长度和直径,以及外侧或内侧半月板的相关损伤情况。对患者进行至少12个月的随访。通过Lysholm膝关节评分和Tegner活动量表评估功能结果。使用Lachman试验,通过屈伸活动度丧失和残余松弛度评估临床结果。采用配对样本t检验比较术前和术后的平均评分。研究结果表明,关节镜下采用四股自体腘绳肌腱进行解剖学前交叉韧带重建是治疗ACL损伤膝关节的有效方法,可改善临床和功能状态。

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