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前交叉韧带重建和翻修的临床疗效及影响因素

The Clinical Efficacy and Risk Factors after Revision and Reconstruction of Anterior Cruciate Ligament.

机构信息

Ningbo Haishu No. 2 Hospital Ningbo First Hospital Haishu Branch, Ningbo, Zhejiang, China.

Ningbo Municipal Hospital of TCM, Ningbo, Zhejiang, China.

出版信息

J Healthc Eng. 2021 Dec 17;2021:6606492. doi: 10.1155/2021/6606492. eCollection 2021.

Abstract

The aim of this study was to study the clinical efficacy and prognostic factors after revision and reconstruction of anterior cruciate ligament. All the patients who underwent the first revision of anterior cruciate ligament (ACL) reconstruction in the department of sports medicine from January 2001 to December 2015 were collected. The demographic information, the first revision and reconstruction information of ACL, and the information during the first ACL reconstruction were collected. A total of 335 cases were included. Lysholm score, Tegner activity score, and IKDC subjective score at the last follow-up were significantly higher than those before operation. Compared with graft failure caused by sports injury, the postoperative scores of patients with revision due to life accidents or initial reconstruction techniques were significantly lower ( < 0.05). The postoperative Lysholm score of patients with femoral canal drilling through the tibial canal was lower than that of patients with anterior internal approach. The postoperative IKDC score of patients who underwent medial meniscus suture at the same time was higher than that of patients without meniscus combined injury. ACL revision can improve the stability and function of knee joint. Compared with the revision caused by life accident or technical reasons of primary reconstruction surgery, the patients with graft failure caused by sports injury have better postoperative recovery. Medial meniscus suture and anterior internal approach drilling of the femoral bone canal have a statistically protective effect on the clinical function after ACL revision.

摘要

本研究旨在探讨前交叉韧带(ACL)翻修重建的临床疗效及其预后因素。收集 2001 年 1 月至 2015 年 12 月运动医学科行首次 ACL 翻修重建的患者资料,记录患者的一般资料、初次 ACL 翻修重建及初次 ACL 重建时的信息。共纳入 335 例患者,末次随访时 Lysholm 评分、Tegner 活动评分和 IKDC 主观评分均明显高于术前。与运动损伤导致的移植物失败相比,因生活意外或初次重建技术导致翻修的患者术后评分明显较低(<0.05)。经胫骨隧道贯穿股骨隧道钻孔的患者术后 Lysholm 评分低于前内入路患者,同期行内侧半月板缝合的患者术后 IKDC 评分高于无合并半月板损伤的患者。ACL 翻修可改善膝关节的稳定性和功能。与生活意外或初次重建手术技术原因导致的翻修相比,因运动损伤导致移植物失败的患者术后恢复更好。内侧半月板缝合和股骨骨道前内入路钻孔对 ACL 翻修后的临床功能具有统计学保护作用。

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本文引用的文献

1
Pediatric Anterior Cruciate Ligament Reconstruction.小儿前交叉韧带重建术
Orthop Clin North Am. 2020 Jan;51(1):55-63. doi: 10.1016/j.ocl.2019.08.009. Epub 2019 Oct 21.
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Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture.循证推荐用于前交叉韧带(ACL)断裂的管理。
Best Pract Res Clin Rheumatol. 2019 Feb;33(1):33-47. doi: 10.1016/j.berh.2019.01.018. Epub 2019 Feb 21.
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Anterior Cruciate Ligament Tear.前交叉韧带撕裂
N Engl J Med. 2019 Jun 13;380(24):2341-2348. doi: 10.1056/NEJMcp1805931.
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Anterior Cruciate Ligament Reconstruction.前交叉韧带重建术
Sports Med Arthrosc Rev. 2018 Dec;26(4):165-167. doi: 10.1097/JSA.0000000000000218.
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Anterior Cruciate Ligament Strain In Vivo: A Systematic Review.体内前交叉韧带拉伤:系统综述。
Sports Health. 2016 Sep;8(5):451-5. doi: 10.1177/1941738116658006. Epub 2016 Jul 14.
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Controversies in knee rehabilitation: anterior cruciate ligament injury.膝关节康复中的争议:前交叉韧带损伤
Clin Sports Med. 2015 Apr;34(2):301-12. doi: 10.1016/j.csm.2014.12.008. Epub 2015 Feb 27.

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