文章简介

出版社:The Knee 21

作   者:M.K. Kim et al.

编   号:10.1016/j.knee.2014.02.011

年   份:2014    点击量:723

文章摘要

Background:

    Although ACL reconstruction is prevalent, the most effective method for ACL reconstruction still remains controversial. The purpose of this study was to evaluate the effect of the preserved remnant in ACL reconstruction on graft morphology at second-look arthroscopy and clinical outcomes.

背景:

    虽然前交叉韧带(ACL)重建很普遍,但其最有效的方法仍有争议。本研究旨在评估ACL重建的保留残端量对关节镜再观察检查中移植物形态及临床预后的影响。

 

Methods:

    66 consecutive patients who underwent a second-look arthroscopy after a remnant-preserving ACL reconstruction were enrolled. The patients were divided into two groups according to whether the remnant ACL fibers could be preserved by over 50% (Group I) or not (Group II). The Lysholm score, IKDC subjective score, Tegner activity score, pivot-shift test, and KT-2000 arthrometric findings were evaluated preoperatively and just prior to the second-look arthroscopy to assess clinical outcomes. At second-look arthroscopy, graft morphology was evaluated using hypertrophy rate and synovialization.

方法:

    将66例患者纳入研究,在ACL重建保留残端后对患者行关节镜再观察检查。根据ACL纤维残余量是否超过50%(超过:第一组;未超过:第二组),将患者分为两组。在关节镜再观察之前,术前先评估Lysholm评分、IKDC主观评分、Tegner活性评分、支点转移试验及KT-2000 关节测试结果,以评估临床预后。在关节镜再观察检查中,利用增生率和滑膜化来评估移植物形态。

 

Results:

    At second-look arthroscopy, the hypertrophy rate of Group I (42.1%) was higher than Group II (25.1%), which was statistically significant (p = 0.002). In graft synovialization, there was a statistically significant difference between the two groups (p<0.001). The IKDC subjective score improved from 42.9, 43.1 to 77.8, 75.0 for Group I and Group II, respectively (p=0.025). For the Lysholm score, Group I and Group II improved from 55.4 and 55.7 to 87.8 and 84.9 (p=0.031).There was also a significant difference between the pivot shift tests between the groups (p = 0.039). Other clinical tests showed no statistically significant differences.

结果:

    在关节镜再观察检查中,第一组的增生率(42.1%)高于第二组(25.1%),其统计学结果显著(P = 0.002)。,两组的移植物滑膜化之间存在显著的统计学差异(p<0.001)。对于IKDC主观评分,第一组从42.9分提高到77.8分,第二组从43.1分提高到75.0分(P = 0.025)。对于Lysholm评分,第一组从55.4分提高到87.8分,第二组从55.7分提高到84.9分(p=0.031)。两组的支点转移试验之间也存在显著差异(p=0.039)。其他临床试验无显著统计学差异。

 

Conclusion:

    Preserving the remnant ACL tissue during ACL reconstruction could have a positive effect on graft hypertrophy, synovialization and clinical outcomes.

结论:

ACL重建过程中保留其残端组织,对移植物增生、滑膜化及临床预后均有积极影响。

 

 

由MediCool医库软件 余娟 编译

原文来自:The Knee 21