镜下全内技术后交叉韧带重建与常规技术比较
Comparison of posterior cruciate ligament reconstruction by all-inside and conventional arthroscopic techniques
刘昭 1白晓东 1杨军 1邢更彦 1张浩冲 1安伯京1
作者信息
- 1. 解放军总医院第三医学中心骨科,北京 100039
- 折叠
摘要
[目的]比较镜下全内技术与常规技术重建后交叉韧带(posterior cruciate ligament,PCL)的临床结果.[方法]回顾性分析2016年7月-2021年7月镜下重建PCL74例患者的临床资料.依据医患沟通结果,31例采用自体半腱肌肌腱为移植物,以全内技术PCL重建(全内组),另外43例采用异体肌腱为移植物,常规镜下PCL重建(常规组).比较两组围手术期、随访及影像资料.[结果]全内组在切口总长度[(7.1±1.3)cm vs(10.3±2.4)cm,P＜0.001]、下地行走时间[(3.4±2.1)d vs(5.6±3.2)d,P＜0.001]、早期并发症发生率(3.2％vs9.3％,P=0.043)、住院时间[(7.4±1.8)d vs(10.3±3.6)d,P＜0.001]均显著优于常规组.全内组恢复完全负重活动时间显著早于常规组[(93.6±11.7)d vs(128.4±12.4)d,P＜0.001].术后两组VAS评分、Lysholm评分、IKDC评级、膝伸屈ROM、后抽屉试验和后向Lachman试验均显著改善(P＜0.05),术后3个月和末次随访时,全内组的膝伸屈活动度[(124.4±3.6)° vs(116.5±3.2)°,P＜0.001;(138.7±3.6)° vs(132.6±5.8)°,P＜0.001]、Lysholm 评分[(124.4±3.6)vs(116.5±3.2),P＜0.001;(138.7±3.6)vs(132.6±5.8),P＜0.001]和IKDC评级均显著优于常规组.影像方面,术后3个月,全内组股骨隧道内口缩小[例,缩小/无变化/扩大,(23/8/0)vs(13/27/3),P＜0.001]占比显著优于常规组(P＜0.05).[结论]应用镜下全内技术PCL重建膝PCL的临床结果优于常规镜下PCL重建.
Abstract
[Objective]To compare the clinical outcomes of posterior cruciate ligament(PCL)reconstruction by all-inside and conven-tional arthroscopic techniques.[Methods]A retrospective study was performed on 74 patients who underwent arthroscopic PCL reconstruc-tion from July 2016 to July 2021.According to doctor-patient discussion,31 patients received all-inside PCL reconstruction with autoge-nous semitendinosus tendon graft(the all-inside group),while the other 43 patients underwent conventional arthroscopic PCL reconstruc-tion with allogeneic tendon graft(the routine group).The perioperative,follow-up and imaging data of the two groups were compared.[Re-sults]The all-inside group proved significantly superior to the routine group in terms of total incision length[(7.1±1.3)cm vs(10.3±2.4)cm,P＜0.001],the walking time[(3.4±2.1)days vs(5.6±3.2)days,P＜0.001],early complication rate(3.2％vs 9.3％,P=0.043)and hospital stay[(7.4±1.8)days vs(10.3±3.6)days,P＜0.001].In addition,the all-inside group resumed full weight-bearing activities significantly earli-er than the routine group[(93.6±11.7)days vs(128.4±12.4)days,P＜0.001].The VAS score,Lysholm score,IKDC grade,knee flexion-ex-tension ROM,posterior drawer test and backward Lachman test significantly improved in both groups over time(P＜0.05).The all-inside group was significantly better than the routine group in terms of knees ROM[(124.4±3.6)° vs(116.5±3.2)°,P＜0.001;(138.7±3.6)° vs(132.6±5.8)°,P＜0.001],Lysholm score[(124.4±3.6)vs(116.5±3.2),P＜0.001;(138.7±3.6)vs(132.6±5.8),P＜0.001]and IKDC grades 3 months postoperatively and at the latest follow-up.Regarding imaging,the all-inside group was also significantly better than the routine group in femoral tunnel variation[case,reduced/no change/enlargement,(23/8/0)vs(13/27/3),P＜0.001].[Conclusion]The all-inside ar-throscopic PCL reconstruction is superior in term of clinical consequence to the conventional arthroscopic PCL reconstruction for this liga-ment rupture.
关键词
关节镜/后交叉韧带重建/半腱肌肌腱移植物/全内技术/常规技术Key words
arthroscopy/posterior cruciate ligament reconstruction/semitendinous tendon graft/all-inside technique/conventional technique引用本文复制引用
出版年
2024
NETL
NSTL
万方数据