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Second-look arthroscopic evaluation of the articular cartilage after primary single-bundle and double-bundle anterior cruciate ligament reconstructions 被引量:12
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作者 WANG Hai-jun AO Ying-fang CHEN Lian-xu GONG Xi WANG Yong-jian MA Yong LEUNG Kevin Kar Ming YU Jia-kuo 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第21期3551-3555,共5页
Background Several reports have shown the progression of articular cartilage degeneration after anterior cruciate ligament (ACL) reconstruction. No report has been published about the cartilage comparing changes aft... Background Several reports have shown the progression of articular cartilage degeneration after anterior cruciate ligament (ACL) reconstruction. No report has been published about the cartilage comparing changes after single-bundle (SB) and double-bundle (DI3) ACL reconstructions. The purpose of this study was to evaluate the articular cartilage changes after SB and DB ACL reconstructions by second-look arthroscopy. Methods Ninety-nine patients who received arthroscopic ACL reconstruction were retrospectively reviewed at an average of 14 months after reconstruction, 58 patients underwent SB ACL reconstruction and 41 patients underwent DB ACL reconstruction. Hamstring tendon autografts were used in all patients. Second-look arthroscopy was done in conjunction with the tibial staple fixation removal at least one year after the initial ACL reconstruction. Arthroscopic evaluation and grading of the articular cartilage degeneration for all patients were performed at the initial ACL reconstruction, and at the second-look arthroscopy. Results The average cartilage degeneration at the patellofemoral joint (PFJ) was found significantly worsened after both SB and DB ACL reconstructions. This worsening were not seen at medial tibiofemoral joint (TFJ) and lateral TFJ. Grade II cartilage damage was the most common. At second-look arthroscopy, the average patellar cartilage degeneration was 1.14±0.14 (at first look 0.52±0.11) for the SB group, and 1.22±0.15 (at first look 0.56±0.12) for the DB group. The average trochlear cartilage degeneration was 1.05±0.16 (at fist look 0.10±0.06) and 0.66±0.17 (at fist look 0.17±0.09), respectively. The average patellar cartilage degeneration showed no significant difference in both groups. However, the average trochlea cartilage degeneration in DB group was significantly less than in SB group. Conclusions Patellofemoral cartilage degeneration continued to aggravate after ACL reconstruction. DB ACL reconstruction could significantly decrease the t 展开更多
关键词 anterior cruciate ligament single bundle double bundle patellofemoral joint cartilage second-look arthroscopy
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FasT-Fix和半月板箭修复半月板术后磁共振成像的信号特点 被引量:9
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作者 江东 敖英芳 +2 位作者 苗羽 郑卓肇 余家阔 《中国微创外科杂志》 CSCD 2013年第11期1021-1025,共5页
目的 比较FasT-Fix和可吸收半月板箭(Arrow)缝合半月板术后磁共振(MRI)的信号特点和差异.方法 2002年9月~ 2008年12月,112名患者(其中12例内外侧半月板均缝合,共124处半月板缝合)接受关节镜下半月板缝合术,FasT-Fix组73处,Arrow... 目的 比较FasT-Fix和可吸收半月板箭(Arrow)缝合半月板术后磁共振(MRI)的信号特点和差异.方法 2002年9月~ 2008年12月,112名患者(其中12例内外侧半月板均缝合,共124处半月板缝合)接受关节镜下半月板缝合术,FasT-Fix组73处,Arrow组51处.患者术前及术后接受MRI扫描,比较两种缝合方式的MRI信号特点和差异,并以二次关节镜探查的结果作为金标准计算MRI对两种缝合方式术后愈合情况的诊断价值.结果 二次关节镜探查证实FasT-Fix组和半月板箭组的愈合率分别为74.0% (54/73)和88.2% (45/51) (Х^2 =3.794,P=0.051);MRI综合T2序列对Arrow组愈合情况诊断的准确性(80.4%,41/51)高于FasT-Fix修复组(65.8%,48/73),但差异无显著性(Х^2=3.176,P=0.075);在综合T2序列中,FasT-Fix组中未愈合半月板出现3度信号的比例[84.2% (16/19) vs.50.0% (3/6),Х^2=26.142,P=0.000]和累及层面[中位数4(1~6) vs.1(0~3),Z=3.060,P=0.002]均明显高于Arrow组.结论 MRI综合T2序列对半月板箭修复术后的愈合诊断更准确,FasT-Fix修复术后的半月板更易出现3度信号. 展开更多
关键词 半月板缝合 FAST-FIX 半月板箭 磁共振 二次关节镜
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自体骨-髌腱-骨和腘绳肌腱单束重建前交叉韧带的愈合形态学和前向稳定性对比 被引量:2
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作者 杨渝平 敖英芳 《中国微创外科杂志》 CSCD 2011年第3期245-248,共4页
目的探讨采用自体骨-髌腱-骨(bone-patellar tendon-bone,B-PT-B)和自体腘绳肌腱(hamstring tendon,HT)进行前交叉韧带(anterior cruciate ligament,ACL)单束重建后的移植物愈合形态和前向稳定性是否存在差异。方法 1996年7月~200... 目的探讨采用自体骨-髌腱-骨(bone-patellar tendon-bone,B-PT-B)和自体腘绳肌腱(hamstring tendon,HT)进行前交叉韧带(anterior cruciate ligament,ACL)单束重建后的移植物愈合形态和前向稳定性是否存在差异。方法 1996年7月~2005年5月,我所对134例急性ACL断裂施行膝关节镜下ACL单束重建,移植物分别为自体B-PT-B和HT,其中51例为去除金属内固定而二次入院手术(术后6~46个月,平均13.8月),根据移植物种类将51例分为2组:B-PT-B组(n=14)和HT组(n=37),比较关节镜下移植物愈合形态,采用膝关节韧带位移测量仪(KT-2000)分别在屈膝30°和90°时测量前向松弛度。结果 B-PT-B组和HT组重建韧带形态学表现如下:韧带完整分别占85.7%(12/14)和86.5%(32/37),断裂〈1/2分别占14.3%(2/14)和13.5%(5/37),2组无统计学差异(χ2=0.000,P=1.000);滑膜完整分别占57.1%(8/14)和64.9%(24/37),部分滑膜覆盖分别占28.6%(4/14)和27.0%(10/37),无滑膜覆盖分别占14.3%(2/14)和8.1%(3/37),2组无统计学差异(χ2=0.501,P=0.779);滑膜内有血管形成分别占57.1%(8/14)和64.9%(24/37),2组无统计学差异(χ2=0.259,P=0.611);有"独眼征"(cyclops)形成分别占14.3%(2/14)和10.8%(4/37),2组无统计学差异(χ2=0.000,P=1.000)。2组前向松弛度在屈膝30°时分别为(2.2±0.5)、(1.8±1.4)mm(t=1.039,P=0.304),90°时分别为(1.2±0.6)、(1.1±0.7)mm(t=0.472,P=0.639)。结论急性期采用自体B-PT-B和HT单束重建ACL,在韧带愈合形态学表现和重建的前向稳定性方面均无显著性差异。 展开更多
关键词 二次关节镜 前交叉韧带重建 自体骨-髌腱-骨 自体腘绳肌腱 韧带形态学
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