[1]吴伟 刘晓峰 严松鹤 王建伟.同种异体肌腱重建踝关节外侧韧带微创治疗踝关节不稳的中期疗效[J].中国中医骨伤科杂志,2019,27(08):76-78.
点击复制

同种异体肌腱重建踝关节外侧韧带微创治疗踝关节不稳的中期疗效()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年08期
页码:
76-78
栏目:
临床报道
出版日期:
2019-07-30

文章信息/Info

文章编号:
1005-0205(2019)08-0076-03
作者:
吴伟1 刘晓峰1 严松鹤1 王建伟1
1江苏无锡市中医医院(南京中医药大学附属无锡医院)创伤 骨科(江苏 无锡,214028)
关键词:
关节镜 微创 踝关节外侧韧带 异体肌腱移植
分类号:
R684.7
文献标志码:
B
摘要:
目的:观察关节镜清理联合同种异体肌腱解剖重建踝关节外侧韧带微创治疗踝关节不稳的中期临床疗效。方法:回顾性分析2011年11月至2016 年5月无锡市中医医院采用关节镜清理联合同种异体肌腱(术中移植前预牵张)解剖重建踝关节外侧韧带微创手术治疗的21例踝关节不稳患者的临床资料,其中男10例,女11例,平均(32±3)岁。根据手术前后美国足踝外科协会(AOFAS)踝关节评分、视觉模拟量表(VAS)评分、距骨倾斜角及距骨前移距离的变化评估患者的手术疗效。结果:所有患者均获得完全随访,随访时间26~55个月,平均随访(40±7)个月。术前和末次随访时AOFAS 踝关节评分分别为(58±4)分和(90±6)分,手术前后比较差异有统计学意义(P<0.01); 末次随访时AOFAS 评分优18例、良1例、中2例,优良率为90%.末次随访时VAS评分及距骨倾斜角、距骨前移距离均较术前明显改善,差异有统计学意义(P<0.01)。末次随访时其中19例无疼痛症状,19例恢复参加体育运动,其中16例达到受伤前水平。结论:关节镜清理联合同种异体肌腱解剖重建踝关节外侧韧带微创手术治疗踝关节不稳,避免了传统大切口手术并发症的发生,移植物固定牢固,中期随访未出现移植韧带的松弛,临床疗效良好。

参考文献/References:

[1] HUBBARD T J,KRAMER L C,DENEGAR C R,et al.Contributing factors to chronic ankle instability[J].Foot Ankle Int,2007,28(3):343-354. [2] O'DRISCOLL J,DELAHUNT E.Neuromuscular training to enhance sensorimotor and functional deficits in subjects with chronic ankle instability:a systematic review and best evidence synthesis[J].Sports Med Arthrosc Rehabil Ther Technol,2011,22(3):19-24. [3] FGIANNINI S,BUDA R,RUFFILLI A,et al.Arthroscopic autologous chondrocyte implantation in the ankle joint[J].Knee Surgery,Sports Traumatology,Arthroscopy,2014,22(6):1311-1319. [4] DIDOMENICO L A,CROSS D J,GIAGNACOVA A.Technique for utilization of an interference screw for split peroneus nrevis tendon transfer in lateral ankle stabilization[J].The Journal of Foot and Ankle Surgery,2014,53(1):114-116. [5] GIZA E,SHIN E C,WONG S E,et al.Arthroscopic suture anchor repair of the lateral ligament ankle complex a cadaveric study[J].The American Journal of Sports Medicine,2013,41(11):2567-2572. [6] 吴伟,刘晓峰,严松鹤,等.预牵张在异体肌腱微创移植重建踝关节外侧韧带中的疗效[J].中国运动医学杂志,2016,35(11):1006-1009. [7] GLAZEBROOK M,EID M,ALHADHOUD M,et al.Percutaneous ankle reconstruction of lateral ligaments[J].Foot Ankle Clin,2018,23(4):581-592. [8] HUNT K J,PEREIRA H,KELLEY J,et al.The role of calcane o fibular ligament injury in ankle instability:implications for surgical management[J].Am J Sports Med,2019,47(2):431-437. [9] TEIXEIRA J,GUILLO S.Arthroscopic treatment of ankle instability-allograft/autograft reconstruction[J].Foot Ankle Clin,2018,23(4):571-579. [10] AHN J H,CHOY W S,KIM H Y.Reconstruction of the lateral ankle ligament with a long extensor tendon graft of the fourth toe[J].The American Journal of Sports Medicine,2011,39(3):637-644. [11] HUA Y,CHEN S,JIN Y,et al.Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft[J].International Orthopaedics,2012,36(10):2027-2031. [12] YOUN H,KIM Y S,LEE J,et al.Percutaneous lateral ligament reconstruction with allograft for chronic lateral ankle instability[J].Foot & Ankle International,2012,33(2):99-104. [13] RIDLEY T J,MACALENA J A,ARENDT E A.Isolated medial patellofemoral ligament reconstruction with semitendinosus tendon allograft[J].JBJS Essent Surg Tech,2018,8(1):e5. [14] SHIBUYA N,BAZáN D I,EVANS A M,et al.Efficacy and safety of split peroneal tendon lateral ankle stabilization[J].J Foot Ankle Surg,2016,55(4):812-816. [15] LI H Y,HUA Y H,WU Z Y,et al.Strength of suture anchor versus transosseous tunnel in anatomic reconstruction of the ankle lateral ligaments:a biomechanical study[J].Arthroscopy,2013,29(11):1817-1825. [16] WANG C W,MUHEREMU A,BAI J P.Use of three-dimensional finite element models of the lateral ankle ligaments to evaluate three surgical techniques[J].J Int Med Res,2018,46(2):699-709. [17] MATTHAI T,GEORGE V M,RAO A S,et al.Biomechanical assessment of an alternative method of staple fixation for anchoring the bone patellar tendon bone graft to the tibia[J].J Clin Orthop Trauma,2018,9(2):157-162. [18] CHANG H,TANG X Y,QU F,et al.Pre-implantation of high-intensity suture into tendon grafts to prevent postoperative graft relaxation and creep in anterior cruciate ligament reconstruction[J].Chinese J Rep & Recons Surg,2017,31(1):42-45. [19] MEYER D C,SNEDEKER J G,WEINERT-APLIN R A,et al.Viscoelastic adaptation of tendon graft material to compression:biomechanical quantification of graft preconditioning[J].Arch Orthop Trauma Surg,2012,132(9):1315-1320.

备注/Memo

备注/Memo:
(收稿日期:2019-03-15)
更新日期/Last Update: 1900-01-01