中国微创外科杂志2024,Vol.24Issue(12) :785-790.DOI:10.3969/j.issn.1009-6604.2024.12.001

股骨骨道过短的膝关节镜下前交叉韧带重建术中固定襻与可调襻应用的比较研究

Comparative Study of Clinical Application of Fixed-loop and Adjustable-loop in Arthroscopic Anterior Cruciate Ligament Reconstruction With Excessively Short Femoral Tunnel

印钰 梅宇 王泽刚 武文杰 刘鹏飞 何鹏峰 宋首一 谢兴
中国微创外科杂志2024,Vol.24Issue(12) :785-790.DOI:10.3969/j.issn.1009-6604.2024.12.001

股骨骨道过短的膝关节镜下前交叉韧带重建术中固定襻与可调襻应用的比较研究

Comparative Study of Clinical Application of Fixed-loop and Adjustable-loop in Arthroscopic Anterior Cruciate Ligament Reconstruction With Excessively Short Femoral Tunnel

印钰 1梅宇 1王泽刚 1武文杰 1刘鹏飞 1何鹏峰 1宋首一 1谢兴1
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作者信息

  • 1. 北京大学第三医院运动医学科,北京 100191
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摘要

目的 探讨在过短股骨骨道的膝关节镜下前交叉韧带重建术中使用固定襻和可调节襻的疗效.方法 2019年1月~2020年7月我院行膝关节镜下前交叉韧带重建术493例,其中股骨骨道<30 mm共57例,最终纳入47例,按股骨端移植物固定方式分为EndoButton组(n=31)和TightRope组(n=16),分别于术后6、12个月采用国际膝关节文献委员会(International Knee Documentation Committee,IKDC)评分、Lysholm 评分和 Tegner 评分评估功能,术后 12 个月采用 Lachman试验和前抽屉试验评估关节松弛度,比较2种固定方式的临床效果.结果 术后第6个月EndoButton组和TightRope组IKDC 评分分别为(64.1±11.0)、(62.6±9.2)分,差异无显著性(t=0.464,P=0.645);Lysholm 评分分别为(81.9±10.6)、(85.3±9.3)分,差异无显著性(t=-1.079,P=0.286);Tegner 评分分别为(2.2±0.9)、(1.9±0.9)分,差异无显著性(t=0.933,P=0.356).术后第12个月EndoButton组和TightRope组IKDC评分分别为(81.4±9.9)、(78.2±9.2)分,差异无显著性(t=1.068,P=0.291);Lysholm 评分分别为(94.6±6.1)、(93.4±7.4)分,差异无显著性(t=0.626,P=0.534);Tegner 评分分别为(3.8±1.0)、(3.4±1.2)分,差异无显著性(t=1.402,P=0.168).2组术后12个月Lachman试验和前抽屉试验比较差异无显著性(Z=-0.039,P=0.969;Z=-0.294,P=0.769).结论 膝关节镜下前交叉韧带重建术中,对于股骨骨道过短(<30 mm),应用EndoButton(15 mm)或TightRope均能达到良好的临床效果.

Abstract

Objective To explore the efficacy of fixed-loop fixation and adjustable-loop fixation in arthroscopic anterior cruciate ligament(ACL)reconstruction with excessively short femoral tunnel.Methods A total of 493 patients undergoing ACL reconstruction at our hospital from January 2019 to July 2020 were reviewed,including 57 patients with femoral tunnel<30 mm and 47 patients ultimately included.According to the fixation method,they were divided into EndoButton group(n=31)and TightRope group(n=16).The International Knee Documentation Committee(IKDC)score,Lysholm score,and Tegner score were used to evaluate joint function at 6 and 12 months postoperatively,respectively.The Lachman test and anterior drawer test were used to evaluate joint laxity at 12 months postoperatively.The clinical effects of the two fixation methods were compared.Results At 6 months postoperatively,the IKDC scores of the EndoButton group and TightRope group were(64.1±11.0)points and(62.6±9.2)points,respectively,with no significant difference(t=0.464,P=0.645).The Lysholm scores were(81.9±10.6)points and(85.3±9.3)points,with no significant difference(t=-1.079,P=0.286).The Tegner scores were(2.2±0.9)points and(1.9±0.9)points,with no statistically significant difference(t=0.933,P=0.356).At 12 months postoperatively,the IKDC scores of the EndoButton group and TightRope group were(81.4±9.3)points and(78.2±9.2)points,with no statistically significant difference(t=1.068,P=0.291).The Lysholm scores were(94.6±6.1)points and(93.4±7.4)points,with no statistically significant difference(t=0.626,P=0.534).The Tegner scores were(3.8±1.0)points and(3.4±1.2)points,with no statistically significant difference(t=1.402,P=0.168).There was no significant difference in the Lachman test and front drawer test between the two groups at 12 months after surgery(Z=-0.039,P=0.969;Z=-0.294,P=0.769).Conclusion In arthroscopic ACL reconstruction surgery,both EndoButton(15 mm)and TightRope can achieve good clinical results for excessively short femoral tunnel(<30 mm).

关键词

前交叉韧带重建术/股骨骨道固定/股骨骨道过短

Key words

Anterior cruciate ligament reconstruction/Femoral tunnel fixation/Excessively short femoral tunnel

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出版年

2024
中国微创外科杂志
北京大学

中国微创外科杂志

CSTPCD北大核心
影响因子:2.21
ISSN:1009-6604
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