应用内支撑技术辅助膝关节前交叉韧带全内重建术近期疗效观察

doi:10.6040/j.issn.1671-7554.0.2024.0998

摘要/Abstract

摘要： 目的探讨关节镜下应用内支撑技术辅助膝关节前交叉韧带全内重建术的近期临床效果。方法选取2022年7月至2023年6月收治于山东第一医科大学附属省立医院骨关节科应用内支撑技术辅助膝关节前交叉韧带全内重建术患者42例。所有患者以自体半腱肌作为移植物,股骨和胫骨端可调节袢钛板双悬吊固定,股骨端钛板穿入高强缝合线或线带,自胫骨端拉出后使用无结锚钉在胫骨骨皮质固定。通过随访术后Lysholm评分、国际膝关节文献委员会(International Knee Documentation Committee, IKDC)主观膝关节评分、拉赫曼试验、轴移试验评估手术的临床疗效。结果 42例患者均手术成功,并获6~12个月随访,平均随访9.7个月。所有患者末次随访均未出现感染、韧带再断裂等并发症。Lysholm评分和IKDC主观膝关节评分分别由术前(50.10±3.19)分和(51.42±4.52)分恢复至末次随访(82.38±2.86)分和(84.89±3.39)分,差异均有统计学意义(P<0.001)。拉赫曼试验术前均为阳性(Ⅱ度17例,Ⅲ度25例),末次随访仅1例阳性(Ⅰ度1例),差异有统计学意义(P<0.001)。轴移试验末次随访均阴性,显著少于术前42例(正常2例,Ⅰ级12例,Ⅱ级28例,Ⅲ级0例),差异有统计学意义(P<0.001)。结论应用内支撑技术辅助膝关节前交叉韧带全内重建术可获得满意的近期临床疗效,显著改善患者膝关节功能和稳定性。

关键词: 前交叉韧带断裂, 膝关节镜, 膝关节前交叉韧带全内重建术, 内支撑技术, 近期疗效

Abstract: Objective To investigate the short-term efficacy of all-inside anterior cruciate ligament reconstruction(ACLR)assisted by internal brace technique under arthroscopy. Methods A retrospective study was performed on 42 patients with all-inside ACLR assisted by internal brace technique who were admitted to the Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from July 2022 to June 2023. The femoral and tibial ends were fixed by double suspension with adjustable loop titanium plates, and the autosemitendinosus for ACL graft. High-strength sutures or wire bands were inserted into the femoral ends of the titanium plates, and then fixed in the tibial cortex with knot-free anchors after pulling out the tibial ends. Clinical outcome was evaluated with International Knee Documentation Committee(IKDC)score, Lysholm score, and knee stability tests(Lachman test and pivot shift test). Results All of the 42 patients underwent successful surgery and were followed up for 6 to 12 months, with an average duration of 9.7 months. At the final follow-up, no complications, such as infection or ligament re-rupture, were observed in any of the patients. The Lysholm score and IKDC score recovered from preoperative 50.10±3.19 and 51.42±4.52 to the last follow-up 82.38±2.86 and 84.89±3.39, respectively, with statistical significance(P<0.001). All Lachman tests were positive before surgery(17 cases of grade Ⅱ and 25 cases of grade Ⅲ), and only 1 case was positive at the last follow-up(1 case of grade Ⅰ), the difference was statistically significant(P<0.001). The pivot shift test was negative at the last follow-up, significantly less than the 42 cases before surgery(2 cases in normal, 12 cases in grade Ⅰ, 28 cases in grade Ⅱ, 0 cases in grade Ⅲ), and the difference was statistically significant(P<0.001). Conclusion The application of all-inside anterior cruciate ligament reconstruction assisted by internal brace technique can obtain satisfactory short-term clinical outcomes, and has a significant improvement in the functional capacity and stability of the patients knee joint.

Key words: Anterior cruciate ligament rupture, Knee arthroscopy, All-inside anterior cruciate ligament reconstruction, Internal Brace, Short-term efficacy

中图分类号:

R684.3

王建旭,彭晓辉,丰浩田,安森博,董恣豪,黄子帅,刘喆,杨光. 应用内支撑技术辅助膝关节前交叉韧带全内重建术近期疗效观察[J]. 山东大学学报 (医学版), 2025, 63(3): 22-27.

WANG Jianxu, PENG Xiaohui, FENG Haotian, AN Senbo, DONG Zihao, HUANG Zishuai, LIU Zhe, YANG Guangsup>1,2. Short-term efficacy of all-inside anterior cruciate ligament reconstruction assisted by internal brace technique[J]. Journal of Shandong University (Health Sciences), 2025, 63(3): 22-27.

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