当前位置: X-MOL 学术J. Knee Surg. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Remnant-Preserved Single-Bundle Anterior Cruciate Ligament Augmentation in Multi-ligamentous Knee Reconstruction
Journal of Knee Surgery ( IF 1.7 ) Pub Date : 2022-06-10 , DOI: 10.1055/s-0042-1749603
Takuya Tajima, Nami Yamaguchi, Yudai Morita, Takuji Yokoe, Makoto Nagasawa, Tomomi Ota, Shuichi Kawagoe, Yoshihiro Nakamura, Etsuo Chosa

This study was conducted to present remnant-preserving anterior cruciate ligament (ACL) augmentation as a useful option for partial ACL injury in multiligament knee injury (MLKI) cases, which may also contribute to conserving graft resources. The present study involved patients diagnosed with MLKI at our institute from Spring 2006 to February 2021. A total of 71 MLKI cases were provided surgery due to knee instability and disability. For every patient, an arthroscopic diagnostic was performed to ensure that ACL tear and a remnant were present. When the ACL remnant was classified into group 2, 3, or 4 of Nakamae's classification, remnant-preserved single bundle ACL augmentation was performed. Graft selection and the combination of injured ligaments were evaluated. The side-to-side difference under an anterior tibial load of 134 N with an arthrometer and the leg symmetry index at 60 degrees/s were measured. The present procedure was performed for five cases (male/female: 4/1, mean age: 33.6 years). The mean follow-up period was 26.4 months. The combination of torn ligaments was as follows: 3 cases of ACL + medial collateral ligament, one case of ACL + posterior cruciate ligament, and one case of ACL + posterolateral corner. An ACL augmentation graft was performed using an ipsilateral gracilis tendon in 2 cases, a contralateral full semitendinosus tendon in 2 cases, and the ipsilateral distal 1/2 of the semitendinosus tendon in 1 case. The mean side-to-side difference was 1.07 ± 0.4 mm. The mean leg symmetry index was 82.6 ± 12.2% in knee extension and 96.3 ± 9.9% in knee flexion. Although the present study was a small case series, the remnant-preserved single-bundle ACL augmentation for MLKI surgery provided good clinical outcome and conserved the graft resource. Even in the MLKI case, this technique is one of the useful surgical options. The level of evidence of this study is level IV (case series).



中文翻译:

多韧带膝关节重建术中保留残余的单束前交叉韧带增强术

本研究旨在提出保留残余前交叉韧带 (ACL) 增强术作为多韧带膝关节损伤 (MLK​​I) 病例中部分 ACL 损伤的有用选择,这也可能有助于节省移植物资源。本研究涉及 2006 年春季至 2021 年 2 月在我院诊断为 MLKI 的患者。由于膝关节不稳定和残疾,共有 71 例 MLKI 病例接受了手术。对于每位患者,都进行了关节镜诊断,以确保存在 ACL 撕裂和残留物。当 ACL 残余被分类为 Nakamae 分类的第 2、3 或 4 组时,进行了保留残余的单束 ACL 增强术。评估了移植物的选择和受伤韧带的组合。用关节计测量胫骨前负荷 134 N 下的侧向差异和 60°/s 的腿部对称指数。对五例(男性/女性:4/1,平均年龄:33.6 岁)进行了本程序。平均随访时间为 26.4 个月。韧带撕裂组合情况:ACL+内侧副韧带3例,ACL+后交叉韧带1例,ACL+后外侧角1例。使用同侧股薄肌腱2例,对侧全半腱肌腱2例,同侧半腱肌远端1/2腱1例进行ACL增强移植。平均左右差异为 1.07 ± 0.4 mm。膝关节伸展时平均腿部对称指数为 82.6 ± 12.2%,膝关节屈曲时为 96.3 ± 9.9%。尽管本研究是一个小型病例系列,但用于 MLKI 手术的保留残余单束 ACL 增强术提供了良好的临床结果并节省了移植物资源。即使在 MLKI 病例中,这种技术也是有用的手术选择之一。本研究的证据级别为 IV 级(病例系列)。

更新日期:2022-06-12
down
wechat
bug