[1]张小亮 康子浩 潘建科 张葆青 刘军 徐逸生 崔苛苛 杨伟毅△.膝关节前交叉韧带断裂合并症的临床病例分析[J].中国中医骨伤科杂志,2019,27(04):32-36.
　ZHANG Xiaoliang KANG Zihao PAN Jianke ZHANG Baoqing LIU Jun XU Yisheng CUI Keke YANG Weiyi.Clinical Analysis of Knee Anterior Cruciate Ligament Rupture Complication[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(04):32-36.
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膝关节前交叉韧带断裂合并症的临床病例分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年04期
页码:
32-36
栏目:
临床研究
出版日期:
2019-04-12

文章信息/Info

Title:
Clinical Analysis of Knee Anterior Cruciate Ligament Rupture Complication
文章编号:
1005-0205(2019)04-0032-05
作者:
张小亮1 康子浩1 潘建科2 张葆青2 刘军2 徐逸生2 崔苛苛1 杨伟毅2△
1广州中医药大学第二临床医学院(广州,510403) 2 广州中医药大学第二临床医学院(广东省中医院骨三科)
Author(s):
ZHANG Xiaoliang1 KANG Zihao1 PAN Jianke2 ZHANG Baoqing2 LIU Jun2 XU Yisheng2 CUI Keke1 YANG Weiyi2△
1Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510403,China; 2Department of Orthopedics, Second Affiliated Hospital, Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine),Guangzhou 510120,China.
关键词:
前交叉韧带断裂;  急慢性期;  半月板;  侧副韧带
Keywords:
anterior cruciate ligament rupture;  acute and chronic group;  meniscus;  collateral ligament
分类号:
R686.5
文献标志码:
A
摘要:
目的:回顾分析不同病程中膝关节前交叉韧带(Anterior Cruciate Ligament,ACL)断裂合并症的分布情况。方法:统计2016年01月01日至2017年12月31日广东省中医院骨三科收治的311例ACL断裂患者的临床资料。将患者按照从受伤到接受手术的不同的时间分为急性期、亚慢性期和慢性期,分析半月板损伤的频率、部位、类型及侧副韧带损伤的发病率与病程的关系。结果:内侧半月板在急性期组损伤率为29.91%,亚慢性期组为51.52%,慢性期组为88.89%; 外侧半月板在急性期组损伤率为41.12%,亚慢性期组为43.18%,慢性期组为48.61%。在不同的病程中,半月板后角损伤率显著大于体部及前角,半月板纵形撕裂的发生率显著大于其他类型的半月板损伤。侧副韧带在急性期组损伤率为60.75%,亚慢性期组为39.39%,慢性期组为18.06%.结论:ACL断裂急性期常合并外侧半月板的损伤,随着病程的延长内侧半月板继发损伤越来越显著,内外侧半月板损伤部位主要以后角为主,损伤类型主要以纵行撕裂为主; ACL断裂急性期常合并侧副韧带损伤,由于侧副韧带损伤有一定的自愈性,随着病程的延长其损伤率逐渐降低。
Abstract:
Objective:Retrospectively analysis the distribution of knee anterior cruciate ligament complication in different course of disease.Methods:A total of 311 patients were enrolled with ACL rupture undergoing arthroscopic anterior cruciate ligament reconstruction from 2016-01-01 to 2017-12-31.The patients were divided into acute group, sub-chronic group and chronic group according to different injury periods.It was analyzed the clinical characteristics of the frequency, location, type of meniscus injury and incidence of collateral ligament in different periods.Results:The incidence of medial meniscus injury was 29.91% in the acute group, 51.52% in the sub-chronic group, and 88.89% in the chronic group; the incidence of lateral meniscus was 41.12% in the acute group, 43.18% in the sub-chronic group, and 48.61% in the chronic phase.In different periods of injury, the incidence of meniscus posterior horn injury is greater than the body and anterior horn.In different periods of injury, the incidence of longitudinal tears in the meniscus is greater than in other types.The incidence of collateral ligament injury was 60.75% in the acute group, 39.39% in the sub-chronic group, and 18.06% in the chronic group.Conclusion:ACL rupture is often accompanied by lateral meniscus injury, and the damage of the medial meniscus increases as the disease progresses.The ACL rupture accompanied by meniscus injury is mainly the posterior horn, and the injury type is mainly longitudinal tear.The incidence of ACL rupture with lateral collateral ligament decreased with prolonged disease duration.

参考文献/References:

[1] FRANK R M,HIGGINS J,BERNARDONI E,et al.Anterior cruciate ligament reconstruction basics:bone-patellar tendon-bone autograft harvest[J].Arthrosc Tech,2017,6(4):1189-1194.
[2] CASSARD X,CAVAIGNAC E,MAUBISSON L,et al.Anterior cruciate ligament reconstruction in children with a quadrupled semitendinosus graft:preliminary results with minimum 2 years of follow-up[J].J Pediatr Orthop,2014,34(1):70-77.
[3] CHAHLA J,MOATSHE G,CINQUE M E,et al.Arthroscopic anatomic single-bundle anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft:pearls for an accurate reconstruction[J].Arthrosc Tech,2017,6(4):1159-1167.
[4] GHODADRA N,MALL N A,KARAS V,et al.Articular and meniscal pathology associated with primary anterior cruciate ligament reconstruction[J].J Knee Surg,2013,26(3):185-193.
[5] XU B,ZHANG H,LI B,et al.Comparison of magnetic resonance imaging for patients with acute and chronic anterior cruciate ligament tears[J].Medicine(Baltimore),2018,97(10):e1.
[6] SNOEKER B A,BAKKER E W,KEGEL C A,et al.Risk factors for meniscal tears:a systematic review including meta-analysis[J].J Orthop Sports Phys Ther,2013,43(6):352-367.
[7] KHOSHNOODI P,TEHRANZADEH A D,DUNN J M,et al.Semimembranosus tendon avulsion fracture of the posteromedial tibial plateau associated with posterior cruciate ligament tear and capsular rupture[J].Skeletal Radiol,2014,43(2):239-242.
[8] KEENE G C,BICKERSTAFF D,RAE P J,et al.The natural history of meniscal tears in anterior cruciate ligament insufficiency[J].Am J Sports Med,1993,21(5):672-679.
[9] LEVY A S,MEIER S W.Approach to cartilage injury in the anterior cruciate ligament-deficient knee[J].Orthop Clin North Am,2003,34(1):149-167.
[10] 陈连旭,付立功.前交叉韧带断裂和重建的临床流行病学分析[J].中国组织工程研究,2016,20(24):3602-3608.
[11] STENSRUD S,RISBERG M A,ROOS E M.Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy[J].Br J Sports Med,2014,48(9):784-788.
[12] KUIKKA P I,PIHLAJAMAKI H K,MATTILA V M.Knee injuries related to sports in young adult males during military service-incidence and risk factors[J].Scand J Med Sci Sports,2013,23(3):281-287.
[13] ABAT F,GELBER P E,ERQUICIA J I,et al.Promising short-term results following selective bundle reconstruction in partial anterior cruciate ligament tears[J].Knee,2013,20(5):332-338.
[14] SMITH J R,BARRETT G R.Medial and lateral meniscal tear patterns in anterior cruciate ligament-deficient knees:a prospective analysis of 575 tears[J].Am J Sports Med,2001,29(4):415-419.
[15] 王成,龚喜,胡晓青,等.前交叉韧带断裂病程时长对半月板损伤及其手术缝合影响的临床研究[J].中国运动医学杂志,2016,35(12):1089-1093.
[16] ILLINGWORTH K D,HENSLER D,CASAGRANDA B,et al.Relationship between bone bruise volume and the presence of meniscal tears in acute anterior cruciate ligament rupture[J].Knee Surg Sports Traumatol Arthrosc,2014,22(9):2181-2186.
[17] OUANEZAR H,THAUNAT M,SAITHNA A,et al.Suture repair of full radial posterior lateral meniscus tears using a central midline portal[J].Arthrosc Tech,2017,6(5):1801-1806.
[18] GUPTA A,SHARIF K,WALTERS M,et al.Surgical retrieval,isolation and in vitro expansion of human anterior cruciate ligament-derived cells for tissue engineering applications[J].J Vis Exp,2014,86.doi:10.3791/51597.

备注/Memo

备注/Memo:
基金项目:广东省科技计划项目(2017ZC0185) 广东省财政厅项目([2014]157,[2018]8) 广东省中医院中医药科学技术研究专项 (YK2013B2N19,YN2015MS15) △通信作者 E-mail:czyangwy@163.com
更新日期/Last Update: 2019-04-12