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踝关节Watson-Jones腱固定术的长期疗效。随访10至18年后的临床及影像学结果。

Long-term results of Watson-Jones tenodesis of the ankle. Clinical and radiographic findings after ten to eighteen years of follow-up.

作者信息

Sugimoto K, Takakura Y, Akiyama K, Kamei S, Kitada C, Kumai T

机构信息

Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan.

出版信息

J Bone Joint Surg Am. 1998 Nov;80(11):1587-96. doi: 10.2106/00004623-199811000-00004.

Abstract

Thirty-seven chronically unstable ankles in thirty-six patients were operated on with use of a Watson-Jones tenodesis. Thirty-four ankles (thirty-three patients) were followed for a mean duration of thirteen years and eight months (range, ten to eighteen years) after the operation. There were nine male and twenty-four female patients. The mean age of the patients was thirty-one years (range, fourteen to fifty-seven years) at the time of the operation and forty-four years (range, twenty-eight to seventy years) at the time of the latest follow-up. At the time of the most recent follow-up evaluation, twenty-seven patients (twenty-eight ankles) were examined directly by one of us and twenty-five patients (twenty-six ankles) also were evaluated radiographically. The other six patients were interviewed, with use of a questionnaire, by telephone. Of the thirty-four ankles, nineteen had an excellent result (grade 1), eleven had a good result (grade 2), three had a fair result (grade 3), and one had a poor result (grade 4) according to the rating system of Good et al. The mean score (and standard deviation) on the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society for the twenty-eight ankles that were examined directly by one of us was 90 +/- 9.3 points (range, 68 to 100 points). Progression of an exostosis at the edge of the joint was detected in eighteen (69 percent) of the twenty-six ankles that were examined radiographically, but narrowing of the joint space was not seen in any ankle. No relationship was detected between the clinical results and radiographic osteoarthrotic changes or the duration of follow-up. The results did not deteriorate over the long term.

摘要

三十六名患者的三十七例慢性不稳定踝关节接受了沃森-琼斯肌腱固定术。对其中三十四名踝关节(三十三例患者)在术后进行了平均十三年零八个月(范围为十年至十八年)的随访。患者中男性九名,女性二十四名。手术时患者的平均年龄为三十一岁(范围为十四岁至五十七岁),最近一次随访时为四十四岁(范围为二十八岁至七十岁)。在最近一次随访评估时,我们中的一人直接检查了二十七例患者(二十八只踝关节),另有二十五例患者(二十六只踝关节)也接受了影像学评估。另外六例患者通过电话问卷进行了访谈。根据古德等人的评分系统,在这三十四只踝关节中,十九例结果为优(1级),十一例为良(2级),三例为中(3级),一例为差(4级)。我们中的一人直接检查的二十八只踝关节在美国矫形足踝协会踝-后足量表上的平均得分(及标准差)为90±9.3分(范围为68至100分)。在接受影像学检查的二十六只踝关节中,十八只(69%)检测到关节边缘有外生骨疣进展,但未发现任何踝关节有关节间隙变窄。未发现临床结果与影像学骨关节炎改变或随访时间之间存在关联。长期来看,结果并未恶化。

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