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
BACKGROUND Anterior cruciate ligament reconstruction(ACLR)has a high incidence of re-tear in younger patients.Despite comparable functional outcomes,the incidence of retear using single and double bundle ACLR methods ...BACKGROUND Anterior cruciate ligament reconstruction(ACLR)has a high incidence of re-tear in younger patients.Despite comparable functional outcomes,the incidence of retear using single and double bundle ACLR methods has not been well reported.AIM To hypothesize that double bundle hamstring ACLR has a lower graft rupture rate compared with single bundle hamstring ACLR grafts in young patients.METHODS One hundred and twelve patients<30 years of age at the time of primary double bundle ACLR were eligible for study participation.91(81.3%)could be contacted,with a mean age of 20.4 years(range 13-29)and mean post-operative follow-up time of 59 mo(range 25-107).Telephone questionnaires evaluated the incidence(and timing)of subsequent re-tear and contralateral ACL tear,further surgeries,incidence and time to return to sport,and patient satisfaction.RESULTS Of the 91 patients,there were 6(6.6%,95%CI:1.4-11.7)ACL graft re-ruptures,with a mean time to re-rupture of 28 mo(range 12-84).Fourteen patients(15.4%)experienced a contralateral ACL rupture and 14 patients(15.4%)required further surgery to their ipsilateral knee.fifty patients(54.9%)returned to pre-injury level of sport.Of those<20 years(n=45),4 patients(8.9%,95%CI:0.4-17.3)experienced a re-rupture,with mean time to re-injury 15 mo(range 12-24).Comparative analysis with existing literature and revealed a non-significant Chisquared statistic of 2.348(P=0.125).CONCLUSION A trend existed toward lower graft rupture rates in young patients undergoing double bundle ACLR utilizing a hamstring autograft,compared with rates reported after single bundle ACLR.展开更多
Background In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle （DB） and single-bundle （SB） anterior cruciate ligament （ACL） reconst...Background In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle （DB） and single-bundle （SB） anterior cruciate ligament （ACL） reconstruction. The aim of this study was to evaluate the clinical results of four-tunnel DB ACL reconstruction.Methods Sixty-four consecutive patients with ACL ruptures from May 2005 to May 2006 were randomly assigned into two groups： 32 cases for SB ACL reconstruction and 32 cases for DB ACL reconstruction. Clinical data, including KT 2000, Biodex test, Lysholm score, Tegner score and IKDC score, were prospectively collected until at least 10 months post-operative.Results The average values of KT 2000 were （1.47±1.17） mm and （1.68±1.14） mm for the SB and DB ACL reconstruction groups at 30° of knee flexion （P 〉0.05）, and were （1.04±0.98） mm and （1.13±0.98） mm at 90° of knee flexion （P 〉0.05）. There were also no significant differences in Lysholm score, Tegner score, IKDC score and Biodex test scores between the two groups （P 〉0.05）. The operation time of DB ACL reconstruction was 20 minutes longer than the SB ACL reconstruction （P 〈0.05）Conclusion Double bundle ACL reconstructions have no obvious clinical advantages over single bundle ACL reconstructions.展开更多
目的观察膝关节镜辅助下内侧髌股韧带(MPFL)重建术治疗青少年急性创伤性髌骨脱位的临床疗效。方法回顾性分析2017年6月至2019年6月因外伤致急性髌骨脱位累及髌骨内侧缘撕脱性骨折在安康市中心医院治疗的30例初次脱位患者的临床资料,所...目的观察膝关节镜辅助下内侧髌股韧带(MPFL)重建术治疗青少年急性创伤性髌骨脱位的临床疗效。方法回顾性分析2017年6月至2019年6月因外伤致急性髌骨脱位累及髌骨内侧缘撕脱性骨折在安康市中心医院治疗的30例初次脱位患者的临床资料,所有患者采用自体半腱肌双束解剖重建内侧髌股韧带,比较患者术前、术后髌骨移动度及髌骨外侧角、髌骨适合角、髌骨倾斜角,采用Lysholm评分评估患者的膝关节功能。结果30例患者均获得随访,平均随访时间为(10.9±2.35)个月;体格检查髌骨倾斜试验、髌骨恐惧试验、髌骨外推试验均阴性,无再脱位发生;术后3 d CT测量髌骨外侧角较术前增加[(8.49°±2.36°)vs(5.25°±1.48°)]、髌股适合角较术前减小[(10.70°±2.12°)vs(20.79°±5.67°)]、髌骨倾斜角较术前减小[(11.83°±1.94°)vs(21.46°±4.79°)],差异均具有统计学意义(P<0.05);术后6个月,膝关节Lysholm评分为(90.67±3.82)分,较术前的(60.41±6.58)分明显提升,差异具有统计学意义(P<0.05)。结论膝关节镜辅助下内侧髌股韧带重建术治疗青少年急性创伤性髌骨脱位,能纠正髌骨运动轨迹不良,改善髌股关节功能,提高患者膝关节运动功能及生活质量,避免髌骨再次脱位发生,短期内效果良好。展开更多
文摘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
文摘BACKGROUND Anterior cruciate ligament reconstruction(ACLR)has a high incidence of re-tear in younger patients.Despite comparable functional outcomes,the incidence of retear using single and double bundle ACLR methods has not been well reported.AIM To hypothesize that double bundle hamstring ACLR has a lower graft rupture rate compared with single bundle hamstring ACLR grafts in young patients.METHODS One hundred and twelve patients<30 years of age at the time of primary double bundle ACLR were eligible for study participation.91(81.3%)could be contacted,with a mean age of 20.4 years(range 13-29)and mean post-operative follow-up time of 59 mo(range 25-107).Telephone questionnaires evaluated the incidence(and timing)of subsequent re-tear and contralateral ACL tear,further surgeries,incidence and time to return to sport,and patient satisfaction.RESULTS Of the 91 patients,there were 6(6.6%,95%CI:1.4-11.7)ACL graft re-ruptures,with a mean time to re-rupture of 28 mo(range 12-84).Fourteen patients(15.4%)experienced a contralateral ACL rupture and 14 patients(15.4%)required further surgery to their ipsilateral knee.fifty patients(54.9%)returned to pre-injury level of sport.Of those<20 years(n=45),4 patients(8.9%,95%CI:0.4-17.3)experienced a re-rupture,with mean time to re-injury 15 mo(range 12-24).Comparative analysis with existing literature and revealed a non-significant Chisquared statistic of 2.348(P=0.125).CONCLUSION A trend existed toward lower graft rupture rates in young patients undergoing double bundle ACLR utilizing a hamstring autograft,compared with rates reported after single bundle ACLR.
文摘Background In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle （DB） and single-bundle （SB） anterior cruciate ligament （ACL） reconstruction. The aim of this study was to evaluate the clinical results of four-tunnel DB ACL reconstruction.Methods Sixty-four consecutive patients with ACL ruptures from May 2005 to May 2006 were randomly assigned into two groups： 32 cases for SB ACL reconstruction and 32 cases for DB ACL reconstruction. Clinical data, including KT 2000, Biodex test, Lysholm score, Tegner score and IKDC score, were prospectively collected until at least 10 months post-operative.Results The average values of KT 2000 were （1.47±1.17） mm and （1.68±1.14） mm for the SB and DB ACL reconstruction groups at 30° of knee flexion （P 〉0.05）, and were （1.04±0.98） mm and （1.13±0.98） mm at 90° of knee flexion （P 〉0.05）. There were also no significant differences in Lysholm score, Tegner score, IKDC score and Biodex test scores between the two groups （P 〉0.05）. The operation time of DB ACL reconstruction was 20 minutes longer than the SB ACL reconstruction （P 〈0.05）Conclusion Double bundle ACL reconstructions have no obvious clinical advantages over single bundle ACL reconstructions.
文摘目的观察膝关节镜辅助下内侧髌股韧带(MPFL)重建术治疗青少年急性创伤性髌骨脱位的临床疗效。方法回顾性分析2017年6月至2019年6月因外伤致急性髌骨脱位累及髌骨内侧缘撕脱性骨折在安康市中心医院治疗的30例初次脱位患者的临床资料,所有患者采用自体半腱肌双束解剖重建内侧髌股韧带,比较患者术前、术后髌骨移动度及髌骨外侧角、髌骨适合角、髌骨倾斜角,采用Lysholm评分评估患者的膝关节功能。结果30例患者均获得随访,平均随访时间为(10.9±2.35)个月;体格检查髌骨倾斜试验、髌骨恐惧试验、髌骨外推试验均阴性,无再脱位发生;术后3 d CT测量髌骨外侧角较术前增加[(8.49°±2.36°)vs(5.25°±1.48°)]、髌股适合角较术前减小[(10.70°±2.12°)vs(20.79°±5.67°)]、髌骨倾斜角较术前减小[(11.83°±1.94°)vs(21.46°±4.79°)],差异均具有统计学意义(P<0.05);术后6个月,膝关节Lysholm评分为(90.67±3.82)分,较术前的(60.41±6.58)分明显提升,差异具有统计学意义(P<0.05)。结论膝关节镜辅助下内侧髌股韧带重建术治疗青少年急性创伤性髌骨脱位,能纠正髌骨运动轨迹不良,改善髌股关节功能,提高患者膝关节运动功能及生活质量,避免髌骨再次脱位发生,短期内效果良好。
