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采用四股腘绳肌技术的前交叉韧带关节镜韧带重建术

Anterior Cruciate Ligament Arthroscopic Ligamentoplasty Using the Four-Strand Hamstring Technique.

作者信息

Yahia Amer

机构信息

Emergency Department, Cheikh Khalifa Bin Zayed Al Nahyan Hospital, Casablanca, MAR.

出版信息

Cureus. 2023 Jun 12;15(6):e40330. doi: 10.7759/cureus.40330. eCollection 2023 Jun.

Abstract

In this study, we looked at the clinical outcomes of individuals who had a symptomatic torn anterior cruciate ligament and had their anterior cruciate ligament repaired using a four-strand hamstring (4SHS) tendon autograft at least two years later. This is a retrospective study of 34 cases of anterior cruciate ligament arthroscopic reconstruction using the four-strand hamstring graft, collected from Traumatology and Orthopedics at Cheikh Khalifa Hospital in Casablanca, Morocco between January 2017 and January 2021. Different surgeons performed the operations. Physical findings and functional scores were recorded before the follow-up physical examination and surgery; thus, knee radiographs have been evaluated. A six-month rehabilitation program was devised following surgery. The average age of the patients was 30 years, with a male predominance of 94%. Thirty patients (88%) reported negative pivot shift tests and the Lachman test. The average Lysholm score enhanced from 59.3 before surgery to 85.29 at the time of the assessment. Three patients (8.82%) with a positive pivot shift test had no background of extra knee damage. In comparison to the appearance on the preoperative radiographs, no proof of progressive degenerative deterioration was found on the follow-up radiographs. All of the patients, however, had tunnel extension. The tibial tunnel grew on average by 18%, while the femoral tunnel grew on average by 30%. In 88% of patients assessed at least two years after surgery, ligamentoplasty of the anterior cruciate ligament using the four-strand hamstring graft eradicated anterior tibial subluxation. The failure rate was overall 10%. The functional knee scores had greatly improved at the time of the follow-up.

摘要

在本研究中,我们观察了有症状的前交叉韧带撕裂且至少在两年后使用四股绳肌(4SHS)肌腱自体移植修复前交叉韧带的个体的临床结局。这是一项回顾性研究,收集了2017年1月至2021年1月期间在摩洛哥卡萨布兰卡谢赫·哈利法医院创伤与骨科进行的34例使用四股绳肌移植物进行前交叉韧带关节镜重建的病例。手术由不同的外科医生进行。在随访体格检查和手术前记录了体格检查结果和功能评分;因此,对膝关节X线片进行了评估。术后制定了为期六个月的康复计划。患者的平均年龄为30岁,男性占比94%。30例患者(88%)报告枢轴移位试验和拉赫曼试验为阴性。Lysholm平均评分从术前的59.3提高到评估时的85.29。3例枢轴移位试验阳性的患者(8.82%)没有膝关节外损伤史。与术前X线片表现相比,随访X线片未发现进行性退行性恶化的证据。然而,所有患者均有隧道延长。胫骨隧道平均增长18%,而股骨隧道平均增长30%。在术后至少两年接受评估的患者中,88%使用四股绳肌移植物进行前交叉韧带韧带成形术消除了胫骨前半脱位。总体失败率为10%。随访时膝关节功能评分有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0032/10338085/2666e9b08326/cureus-0015-00000040330-i01.jpg

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