中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (29): 4640-4644.doi: 10.3969/j.issn.2095-4344.2015.29.010

• 骨髓干细胞 bone marrow stem cells • 上一篇    下一篇

保留与非保留残端的前交叉韧带重建：6个月随访

王  峻1，李  雁2，于腾波1，张其亮2   

  1. 1青岛大学附属医院骨科，山东省青岛市  266071；
    2青岛市市立医院(东院区)骨科，山东省青岛市   266071
  • 出版日期:2015-07-09 发布日期:2015-07-09
  • 通讯作者: 张其亮，博士，副主任医师，主要从事关节镜微创、运动创伤及康复方面的研究。
  • 作者简介:王峻，男，1971年生，山东省莱阳市人，汉族，青岛大学在读博士，副主任医师，主要从事关节镜微创、运动创伤方面的研究。
  • 基金资助:

    青岛市医疗卫生优秀人才培养项目资助 (V市YQ2014Y310)

Anterior cruciate ligament reconstruction with or without remnant preservation: a 6-month follow-up 

Wang Jun1, Li Yan2, Yu Teng-bo1, Zhang Qi-liang2   

  1. 1Department of Orthopedics, the Affiliated Hospital of Qingdao University, Qingdao 266071, Shandong Province, China; 
    2Department of Orthopedics, Qingdao Municipal Hospital (Eastern Area), Qingdao 266071, Shandong Province, China
  • Online:2015-07-09 Published:2015-07-09
  • Contact: Zhang Qi-liang, M.D., Associate chief physician, Department of Orthopedics, Qingdao Municipal Hospital (Eastern Area), Qingdao 266071, Shandong Province, China
  • About author:Wang Jun, Studying for doctorate, Associate chief physician, Department of Orthopedics, the Affiliated Hospital of Qingdao University, Qingdao 266071, Shandong Province, China
  • Supported by:

    Qingdao Outstanding Health Professional Development Fund, No. YQ2014Y310

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摘要：

背景：近年来，应用残端保留技术进行前交叉韧带重建的病例逐年增多，对于其临床效果，尤其是改善前交叉韧带重建后本体感觉恢复方面的效果还存在争议。
目的：随机、对照观察关节镜下保留残端与非保留残端前交叉韧带重建的临床效果差异。
方法：关节镜下前交叉韧带重建的患者146例，将患者随机分为2组，每组73例，分别行保留残端重建及非保留残端重建，两组患者均选择自体半腱股薄肌腱为移植物。重建前及重建后6，12个月检测并记录患者膝关节的屈伸活动度、Lysholm评分，IKDC评分并检测膝关节的稳定性。重建前及重建后3，6，12个月测试患者膝关节的本体感觉情况，比较分析两组患者测试结果的差异及与健侧肢体的差异。
结果与结论：重建后有114例患者获得超过12个月随访，其中保留残端组61例，非保留残端组53例。两组患者重建后6，12个月患侧膝关节的活动度、Lysholm评分，IKDC评分及膝关节稳定性较术前有明显提高(P < 0.01)。两组比较，重建后6个月保留残端组患侧膝关节的 Lysholm评分，IKDC评分及膝关节稳定性优于非保留残端组(P > 0.05)。两组患者重建后3个月、6个月及1年的本体感觉均显著优于重建前(P < 0.01)。重建后3个月、6个月保留残端组膝关节本体感觉优于非保留残端组(P < 0.05)。结果提示前交叉韧带保残重建能更快的促进膝关节的功能恢复及本体感觉恢复。


中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 组织构建, 组织工程, 前交叉韧带重建, 残端, 本体感觉, 关节镜

Abstract:

BACKGROUND: In recent years, the number of cases of anterior cruciate ligament reconstruction with remnant preservation is increased year by year, but its clinical results, especially effects on improving proprioceptive recovery after reconstruction, are still controversial. 
OBJECTIVE: To compare the clinical effects of arthroscopic anterior cruciate ligament reconstruction with or without remnant preservation.
METHODS: Totally 146 patients undergoing arthroscopic anterior cruciate ligament reconstruction were randomly divided into two groups; preserving-remnant group and removing-remnant group. Autologous hamstring tendons were selected. Evaluation of knee mobility, Lysholm score, IKDC scores and knee stability was performed before and 6, 12 months after reconstruction. Proprioception was recorded before and 3, 6 and 12 months after reconstruction. The comparative analysis was carried out on these data between the group and between affected and healthy limbs. 
RESULTS AND CONCLUSION: 114 patients were followed up for over 12 months, including 61 in the preserving-remnant group and 53 in the removing-remnant group. There were significantly statistical improvements in knee mobility, Lysholm score, IKDC score and knee stability at 6 and 12 months after reconstruction in the two groups (P < 0.01), and the Lysholm score, IKDC score and knee stability were better in the removing-remnant group than the removing-remnant group at 6 months after reconstruction (P > 0.05). The knee proprioception was significantly improved at 3, 6 and 12 months after reconstruction in the two groups (P < 0.01), and it was also better in the removing-remnant group than the removing-remnant group at 3 and 6 months after reconstruction (P < 0.05). These findings indicate that the anterior cruciate ligament reconstruction with remnant preservation is beneficial to the recovery of postoperative proprioception and knee function. 

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Anterior Cruciate Ligament, Proprioception, Arthroscopes

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