AIM To present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System(LARS) artificial ligament to reconstruct posterior cruciate ligament(PCL).METHODS ...AIM To present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System(LARS) artificial ligament to reconstruct posterior cruciate ligament(PCL).METHODS From September 1997 to June 2010, thirty-eight complex knee injuries were treated, where early arthroscopic PCL reconstructions were undergone, using the LARS(Surgical Implants and Devices, Arc-sur-Tille, France) artificial ligament. Exclusion criteria were: Late(> 4 wk) reconstruction, open technique, isolated PCL reconstruction, knee degenerative disease, combinedfracture or vascular injury and use of allograft or autograft for PCL reconstruction. Clinical and functional outcomes were assessed with IKDC Subjective Knee Form, KOS-ADLS questionnaire, Lysholm scale and SF-12 Health Survey. Posterior displacement(PD) was measured with the Telos Stress Device. RESULTS Seven patients were excluded; two because of coexisting knee osteoarthritis and the remaining five because of failure to attend the final follow-up. The sample consisted of 31 patients with mean age at the time of reconstruction 33.2 ± 12.5 years(range 17-61). The postoperative follow-up was on average 9.27 ± 4.27 years(range 5-18). The mean average IKDC and KOS scores were 79.32 ± 17.1 and 88.1 ± 12.47% respectively. Average PD was 3.61 ± 2.15 mm compared to 0.91 ± 1.17 mm in the uninjured knees(one with grade 1+ and two with grade 2 +). Dial test was found positive in one patient, whereas the quadriceps active drawer test was positive in three patients. None was tested positive on the reverse-pivot shift test. The range of motion(ROM) was normal in thirty knees, in comparison with the contralateral one. There was no extension deficit. Osteoarthritic changes were found in three knees(9.6%).CONCLUSION Early treatment of complex knee injuries, using LARS artificial ligament for PCL reconstruction sufficiently reduces posterior tibia displacement and provides satisfactory long-term functional outcomes.展开更多
目的观察后方韧带复合体回植重建椎管内肿瘤切除术后的脊柱稳定性。方法回顾性分析总结我科2008年7月至2013年7月43例确诊为椎管内肿瘤患者的临床资料,43例患者均采用微型钛板对游离的椎板进行固定。观察患者术后有无并发症,术后6个月X...目的观察后方韧带复合体回植重建椎管内肿瘤切除术后的脊柱稳定性。方法回顾性分析总结我科2008年7月至2013年7月43例确诊为椎管内肿瘤患者的临床资料,43例患者均采用微型钛板对游离的椎板进行固定。观察患者术后有无并发症,术后6个月X线、CT影像学复查截骨断面是否愈合、椎管宽度是否良好。结果手术时间130~220 min,平均150 min。失血量200~750 m L,平均340 m L。术后随访6~42个月,所有病例术后未出现医源性脊髓损伤,未出现动脉损伤、脊髓损伤、脊神经根局部异常积液等并发症,术后动力位片显示棘突椎板回植术后脊柱活动度基本得以保留。结论微型钛板固定通过回植后方韧带复合体可恢复脊柱的稳定性,在治疗椎管内肿瘤方面具有良好的优越性和临床可行性。展开更多
文摘AIM To present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System(LARS) artificial ligament to reconstruct posterior cruciate ligament(PCL).METHODS From September 1997 to June 2010, thirty-eight complex knee injuries were treated, where early arthroscopic PCL reconstructions were undergone, using the LARS(Surgical Implants and Devices, Arc-sur-Tille, France) artificial ligament. Exclusion criteria were: Late(> 4 wk) reconstruction, open technique, isolated PCL reconstruction, knee degenerative disease, combinedfracture or vascular injury and use of allograft or autograft for PCL reconstruction. Clinical and functional outcomes were assessed with IKDC Subjective Knee Form, KOS-ADLS questionnaire, Lysholm scale and SF-12 Health Survey. Posterior displacement(PD) was measured with the Telos Stress Device. RESULTS Seven patients were excluded; two because of coexisting knee osteoarthritis and the remaining five because of failure to attend the final follow-up. The sample consisted of 31 patients with mean age at the time of reconstruction 33.2 ± 12.5 years(range 17-61). The postoperative follow-up was on average 9.27 ± 4.27 years(range 5-18). The mean average IKDC and KOS scores were 79.32 ± 17.1 and 88.1 ± 12.47% respectively. Average PD was 3.61 ± 2.15 mm compared to 0.91 ± 1.17 mm in the uninjured knees(one with grade 1+ and two with grade 2 +). Dial test was found positive in one patient, whereas the quadriceps active drawer test was positive in three patients. None was tested positive on the reverse-pivot shift test. The range of motion(ROM) was normal in thirty knees, in comparison with the contralateral one. There was no extension deficit. Osteoarthritic changes were found in three knees(9.6%).CONCLUSION Early treatment of complex knee injuries, using LARS artificial ligament for PCL reconstruction sufficiently reduces posterior tibia displacement and provides satisfactory long-term functional outcomes.
文摘目的观察后方韧带复合体回植重建椎管内肿瘤切除术后的脊柱稳定性。方法回顾性分析总结我科2008年7月至2013年7月43例确诊为椎管内肿瘤患者的临床资料,43例患者均采用微型钛板对游离的椎板进行固定。观察患者术后有无并发症,术后6个月X线、CT影像学复查截骨断面是否愈合、椎管宽度是否良好。结果手术时间130~220 min,平均150 min。失血量200~750 m L,平均340 m L。术后随访6~42个月,所有病例术后未出现医源性脊髓损伤,未出现动脉损伤、脊髓损伤、脊神经根局部异常积液等并发症,术后动力位片显示棘突椎板回植术后脊柱活动度基本得以保留。结论微型钛板固定通过回植后方韧带复合体可恢复脊柱的稳定性,在治疗椎管内肿瘤方面具有良好的优越性和临床可行性。
