克什米尔人使用髌骨腱骨自体移植进行关节镜辅助前交叉韧带重建术的效果评估

Dr. Bilal Ahmad Lone, Dr. Suheel Mushtaq, Dr. Ishfaq Sadiq Mir, Dr. Inayat Rahim, Dr. Shahid Shabir
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摘要

简介通过骨-髌腱-骨自体移植手术重建前交叉韧带是重建膝关节运动学的一种尝试。它具有骨与骨愈合的额外优势,而且不会牺牲膝关节稳定器。本研究旨在评估克什米尔人使用髌腱骨自体移植进行关节镜辅助前交叉韧带重建的效果。材料和方法:这项前瞻性研究针对 30 名经临床检查和核磁共振成像分析发现前交叉韧带损伤的患者。所有患者均采用髌骨肌腱自体骨移植术进行关节镜重建。术后根据 IKDC 主观评分、手动拉赫曼分级、前抽屉值、枢轴移位分级和 Lysholm 评分进行评估。结果:在我们的研究中,术前和术后拉赫曼分级的中位值分别为 3(范围 1-3)和 0(范围 0-1)。术前和术后前抽屉中位值分别为 3(范围 0-3)和 0(范围 0-1)。我们研究的术前和术后枢轴移位分级中位值分别为2(范围1-3)和0(范围0-2)。术前 IKDC 主观评分的平均值为 49.86(49.9-52.8),术后评分的平均值为 89.48(87.9-91.2)。根据 Lysholm 膝关节评分,15 名(50%)患者的功能预后极佳,10 名(33%)患者预后良好,其余 5 名(17%)患者预后一般。结论关节镜下前交叉韧带重建与骨-髌腱-骨移植是前交叉韧带缺损膝关节的最佳治疗方案,可提供稳定的膝关节,并发症极少。
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Assessment of outcome of arthroscopic assisted ACL reconstruction using bone patellar tendon bone auto-graft in Kashmiri population
Introduction: The surgical reconstruction of the anterior cruciate ligament with Bone - Patellar tendon - Bone auto-graft represents an attempt to re-establish knee kinematics. It has the added advantage of bone to bone healing and it does not sacrifice the knee stabilizers. The present study was carried out to assess the outcome of arthroscopic assisted ACL reconstruction using Bone Patellar Tendon Bone auto-graft in Kashmiri population. Materials and Methods: This prospective study was carried on 30 patients with correlative findings of ACL injury on clinical examination and MRI analysis. All patients were managed with arthroscopic reconstruction using Bone Patellar Tendon Bone auto-graft. Postoperative evaluation was done on the basis of IKDC subjective score, Manual Lachman grading, Anterior Drawer value, Pivot Shifting grading and Lysholm scoring. Results: In our study median pre-operative and post-operative Lachman grading value was 3 (range 1-3) and 0 (range 0-1) respectively. Median pre-operative and post-operative anterior drawer value was 3 (range 0-3) and 0 (range 0-1) respectively. Median pre-operative and post-operative pivot shift grading value in our study was 2 (range 1-3) and 0 (range 0-2) respectively. The mean pre-operative IKDC subjective score was 49.86 (49.9-52.8) while the mean postoperative score was 89.48 (87.9-91.2). According to Lysholm knee score 15 (50%) patients had excellent functional outcome while 10 (33%) patients had good outcome and the remaining 5 (17%) patients had a fair outcome. Conclusion: Arthroscopic anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft is an excellent treatment option for anterior cruciate ligament deficient knees and provides a stable knee with minimal complications.
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