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Three-dimensional finite element analysis of ligaments of lumbar spine
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作者 戴力扬 屠开元 +1 位作者 张文明 成培来 《Journal of Medical Colleges of PLA(China)》 CAS 1992年第2期132-135,140,共5页
The lumbar ligaments play an important role in spinal biomechanics.The results ofthree-dimensional finite dement analysis showed that one of the functions of lumbar ligaments istransmission of the tensile load between... The lumbar ligaments play an important role in spinal biomechanics.The results ofthree-dimensional finite dement analysis showed that one of the functions of lumbar ligaments istransmission of the tensile load between the lumbar vertebrae.The anterior longitudinal ligament isloaded in extension of lumbar spine and the resistance to the tensile load in flexion is providedby other ligaments.These ligaments are subject to much more tension with degeneration of theintervertebral disc so that a series of pathological changes occur.Relevant significance in clinical as-pect is also discussed. 展开更多
关键词 BIOMECHANICS LUMBAR VERTEBRAE ligaments articular HUMAN
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Complex knee injuries treated in acute phase: Long-term results using Ligament Augmentation and Reconstruction System artificial ligament 被引量:4
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作者 John Gliatis Konstantinos Anagnostou +3 位作者 Pantelis Tsoumpos Evdokia Billis Maria Papandreou Spyridon Plessas 《World Journal of Orthopedics》 2018年第3期24-34,共11页
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
关键词 COMPLEX KNEE injuries POSTERIOR CRUCIATE ligament Acute RECONSTRUCTION ligament Augmentation and RECONSTRUCTION System
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Lateral femoral tunnel preparation and graft fixation for anterior cruciate ligament reconstruction–A discussion
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作者 Mehak Chandanani Andrea Volpin 《World Journal of Clinical Cases》 SCIE 2024年第17期3277-3280,共4页
This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft ... This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research. 展开更多
关键词 Anterior cruciate ligament reconstruction Arthroscopic surgery Lateral femoral tunnel Graft fixation techniques Anterior cruciate ligament tear BIOMECHANICS Knee injuries
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Recent research progress from biological perspective on the mechanism of formation of osteoarthritis after anterior cruciate ligament injury
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作者 ZHOU Kai DU Xiu-pan WANG Guang-ji 《Journal of Hainan Medical University》 CAS 2024年第4期60-64,共5页
The anterior cruciate ligament(ACL)mainly plays a role in stabilizing the knee joint by limiting the forward translation of tibial force and rotational force at the tibial joint,and if this ligament is damaged,it will... The anterior cruciate ligament(ACL)mainly plays a role in stabilizing the knee joint by limiting the forward translation of tibial force and rotational force at the tibial joint,and if this ligament is damaged,it will cause joint pain,limited mobility,knee instability,etc.According to related studies,the incidence of traumatic osteoarthritis(PTOA)after ACL injury is as high as 87%,although many studies have shown that patients with ACL injury are susceptible to PTOA,but the exact mechanism is currently unknown.This may be related to biological,structural,and mechanical factors caused by the ligament injury.Previous studies have shown that elevated inflammatory mediators in the joint cavity following ACL injury can lead to chondrocytes necrosis and degradation of the cartilage matrix.These potential biochemical mediators contribute to PTOA formation,and early intervention can reduce future episodes of PTOA.In recent years,many scholars have devoted themselves to studying the potential important factors and signaling pathways involved in the formation of osteoarthritis after ACL injury,and exploring its molecular mechanism,which has led to great progress in this field.This paper mainly studies and discusses the mechanism of osteoarthritis formation after ACL injury from the biological perspective. 展开更多
关键词 Anterior cruciate ligament injury BIOLOGY OSTEOARTHRITIS
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Consensus Delphi study on guidelines for the assessment of anterior cruciate ligament injuries in children
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作者 Angélica Campón Chekroun Jorge Velázquez-Saornil +7 位作者 Isabel Guillén Vicente Zacarías Sánchez Milá David Rodríguez-Sanz Carlos Romero-Morales Tomas Fernandez-Jaén JoséIgnacio Garrido González MiguelÁngel Sánchez-Garrido Pedro Guillén García 《World Journal of Orthopedics》 2022年第9期777-790,共14页
Background:Knee examination guidelines in minors are intended to aid decisionmaking in the management of knee instability.Clinical question:A Delphi study was conducted with a formal consensus process using a validate... Background:Knee examination guidelines in minors are intended to aid decisionmaking in the management of knee instability.Clinical question:A Delphi study was conducted with a formal consensus process using a validated methodology with sufficient scientific evidence.A group consensus meeting was held to develop recommendations and practical guidelines for use in the assessment of instability injuries in children.Key findings:there is a lack of evidence to analyse anterior cruciate ligament injuries in children and their subsequent surgical management if necessary.Diagnostic guidelines and clinical assessment of the patient based on a thorough examination of the knee are performed and a guide to anterior cruciate ligament exploration in children is developed.Clinical application:In the absence of a strong evidence base,these established guidelines are intended to assist in that decision-making process to help the clinician decide on the most optimal treatment with the aim of benefiting the patient as much as possible.Following this expert consensus,surgical treatment is advised when the patient has a subjective sensation of instability accompanied by a pivot shift test++,and may include an anterior drawer test+and a Lachman test+.If these conditions are not present,the conservative approach should be chosen,as the anatomical and functional development of children,together with a physiotherapy programme,may improve the evolution of the injury. 展开更多
关键词 Anterior cruciate ligament Diagnoses and examinations Sports injuries KNEE Injury to minors
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The Prevalence Type of the Meniscus Tear in Patients with Anterior Cruciate Ligament (ACL) Injury, in Abu Arish General Hospital, Jazan, KSA
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作者 Eissa Gobran A. Bakri 《Open Journal of Applied Sciences》 2024年第7期1625-1636,共12页
Background: The anterior cruciate ligament (ACL) is the main structure that prevents the forward movement of the tibia about the femur Meniscus tear which is a common finding in patients with anterior cruciate ligamen... Background: The anterior cruciate ligament (ACL) is the main structure that prevents the forward movement of the tibia about the femur Meniscus tear which is a common finding in patients with anterior cruciate ligament (ACL) injury. Aim: To investigate the prevalence of types of meniscus tears in patients with Anterior Cruciate Ligament (ACL) Injury. Methods: A retrospective study was conducted among inpatients. Clinical evaluation included side-to-side difference in anterior tibial translation (ATT) as measured by a KT-1000 arthrometer (MEDmetric Corp) and a grade of pivot-shift test at final follow-up in all patients. Subsequent meniscal tear was defined by symptoms of joint line pain and/or locking or joint effusion requiring surgical treatment. Results: Most of patients were males (92.6%). The patients were categorized into 5 groups according to age with a mean of age 32.8 ± 10.6. The most common causes of ACL injury were falling down (43.2%), trauma (38.1%) or knee torsion (18.8%). Medial meniscal tear was found in 92 knees (55.7%), while lateral meniscal tear was found in 19 knees (10.8%) and the most common type was the longitudinal tear that was found in 31 knees (17.6%). Similarly, 66.7% of the meniscal flap tears and half of the meniscal bucket-handle tears were significantly associated with loose body (P Conclusion: The present study demonstrated that meniscus tears are more common in individuals with chronic ACL rupture. The main factors contributing to ACL injury were classified as falls, trauma, and knee torsion. Gender was identified as a critical determinant in the etiology of ACL injury. The occurrence of a ramp lesion was associated longitudinal meniscal tears, whereas chodoral injury was associated with the majority of meniscal flap tears and meniscal bucket-handle tears. 展开更多
关键词 PREVALENCE TYPE MENISCUS TEAR Anterior Cruciate ligament ACL INJURY
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Analysis of the Application of Sports Medicine Ultrasound in the Rehabilitation of Anterior Talofibular Ligament Injury
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作者 Ling Dong Yanyan Chu 《Proceedings of Anticancer Research》 2024年第3期144-149,共6页
Objective: To explore the application effect of sports medicine ultrasound in the rehabilitation treatment of anterior talofibular ligament injury. Methods: 36 patients who visited our hospital from January 2020 to Se... Objective: To explore the application effect of sports medicine ultrasound in the rehabilitation treatment of anterior talofibular ligament injury. Methods: 36 patients who visited our hospital from January 2020 to September 2023 were selected as research subjects and randomly divided into the study group (18 cases) and the control group (18 cases). The control group adopted routine examination and rehabilitation training, and the study group adopted sports medicine ultrasound and rehabilitation training. The ankle function scores and daily living ability of the two groups were compared before treatment and 9 weeks after treatment. Results: There was no statistically significant difference between the study group and the control group in terms of ankle function scores and ability to perform activities of daily living before treatment (P > 0.05), but the difference was statistically significant after treatment (P < 0.05). Conclusion: Ultrasound can be used as a supplement to magnetic resonance imaging (MRI) of the ankle joint for diagnosing anterior talofibular ligament injury;ultrasound can show the location, distance, and degree of tear of the anterior talofibular ligament rupture and accurately predict muscle atrophy around the ankle joint;ultrasound combined with computed tomography (CT) can better determine the type of intra-articular fracture of the talar subtalar joint, and guide the choice of surgical timing. In addition, ultrasound can be used to determine the severity of peroneal muscle atrophy, assess the progress of early postoperative functional exercise, and guide personalized rehabilitation programs. 展开更多
关键词 Sports medicine ultrasound Anterior talofibular ligament injury REHABILITATION
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Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament 被引量:2
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作者 Run-Peng Chen Qing-Hua Wang +4 位作者 Ming-Yue Li Xiao-Fang Su Dong-Yang Wang Xing-Hui Liu Zhi-Li Li 《World Journal of Clinical Cases》 SCIE 2023年第15期3395-3407,共13页
Injury to the anterior talofibular ligament(ATFL)is a common acute injury of the lateral foot ligament.Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients.... Injury to the anterior talofibular ligament(ATFL)is a common acute injury of the lateral foot ligament.Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients.The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL.The clinical manifestations of acute injury to the ATFL include pain,swelling,and dysfunction.At present,non-surgical treatment is the first choice for acute injury of the ATFL.The standard treatment strategy involves the“peace and love”principle.After initial treatment in the acute phase,personalized rehabilitation training programs can be followed.These may involve proprioception training,muscle training,and functional exercise to restore limb coordination and muscle strength.Static stretching and other techniques to loosen joints,acupuncture,moxibustion massage,and other traditional medical treatments can relieve pain,restore range of motion,and prevent joint stiffness.If the non-surgical treatment is not ideal or fails,surgical treatment is feasible.Currently,arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice.Although open Broström surgery provides good results,the modified arthroscopic Broström surgery has many advantages,such as less trauma,rapid pain relief,rapid postoperative recovery,and fewer complications,and is more popular with patients.In general,when treating acute injury to the ATFL,treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results. 展开更多
关键词 Anterior talofibular ligament Acute injury DIAGNOSIS AETIOLOGY TREATMENT
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Functional Outcomes for Combined Acute Anterior and Posterior Cruciate Knee Injuries Treated Non-Operatively
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作者 Naoki Wada Masashi Kimura +2 位作者 Masayuki Tazawa Yoko Ibe Kenji Shirakura 《Open Journal of Orthopedics》 2014年第7期169-175,共7页
Introduction: results after non-operative management for knees sustaining combined acute anterior and posterior cruciate ligament tears were presented. Subjects: 13 patients, 10 with medial, and 3 with lateral ligamen... Introduction: results after non-operative management for knees sustaining combined acute anterior and posterior cruciate ligament tears were presented. Subjects: 13 patients, 10 with medial, and 3 with lateral ligament injury. Methods: non-operative management consisted of employing a brace to prevent sagittal translation of the tibia. Quadriceps muscle and early passive knee motion exercises in the brace was encouraged immediately after arthroscopy. Weight-bearing was forbidden for 3 weeks. The brace was not removed for 3 months. Follow-up periods ranged from 2 to 6 years (mean, 3 years 2 months). Results: none, but one patient had a slight restriction of knee flexion. Quadriceps muscle strength revealed an average of 89.0% of normal side. The knee score indicated 2 patients rated good, 3 rated fair, and 8 rated poor. The score correlated with measurements of anterior and posterior translation on the stress radiograph significantly. Stress radiography revealed that anterior laxity was reduced better than posterior laxity significantly. Conclusion: non-operative brace therapy can be considered for this combined injury as the initial treatment. A late reconstruction would be performed when the result was not satisfactory. Preserved range of motion and muscle strength after brace therapy had a great advantage to the late reconstructive surgery. 展开更多
关键词 KNEE Multiple ligament Injury NON-OPERATIVE Management ANTERIOR CRUCIATE ligament POSTERIOR CRUCIATE ligament
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Demographic characteristics of patients who underwent anterior cruciate ligament reconstruction at a tertiary care hospital in India
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作者 Sai Krishna Mlv Asjad Mahmood +3 位作者 Pulak Vatsya Siva Srivastava Garika Ravi Mittal Manoj Nagar 《World Journal of Clinical Cases》 SCIE 2023年第15期3464-3470,共7页
BACKGROUND Anterior cruciate ligament(ACL)tears are common sports-related injuries.Their incidence is not the same either for all the sports or for the same sport across various nations.This information is maintained ... BACKGROUND Anterior cruciate ligament(ACL)tears are common sports-related injuries.Their incidence is not the same either for all the sports or for the same sport across various nations.This information is maintained by many sports leagues in their registries.However,very few nationwide registries exist for such injuries.This study is carried out to know the demographic characteristics of patients who underwent ACL reconstruction at our hospital in India.AIM To know the demographic characteristics of patients who underwent ACL reconstruction at a tertiary care hospital in India.METHODS All the patients who underwent ACL reconstruction from January 2020 to December 2021 were retrospectively studied.Patients with multi-ligament injuries or a history of previous knee surgery were excluded.The patients’history was obtained from the hospital records,they were interviewed telephonically,and online questionnaires were given.Their demographic data was analyzed and compared to the existing literature.RESULTS A total of 124 patients were operated on for ACL reconstruction during this period.The mean age of the patients was 27.97 years.One hundred and thirteen patients(91.1%)were male and 11(8.9%)were female.The majority of the patients(47.6%)sustained this injury by road traffic accidents(RTA)followed by sportsrelated injuries(39.5%).The commonest presenting complaint was giving way of the knee in 118 patients(95.2%).The mean duration from the injury to the first hospital visit among the patients was 290.1 d.The mean duration from the injury to surgery was 421.8 d.CONCLUSION ACL patients’demography is different in developing nations as compared to the developed world.RTA are the leading cause of ACL injuries and are followed by recreational sports as a cause.There is delayed access to healthcare leading to delayed diagnosis as well as even greater time to surgery.This,in turn,leads to poorer prognosis and longer rehabilitation.National registries for developing nations are the need of the hour due to the different demographics of ACL injuries in developing countries. 展开更多
关键词 Anterior cruciate ligament Sports injury DEMOGRAPHY EPIDEMIOLOGY KNEE
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关节腔内移植物长度测量在前交叉韧带全内重建的应用研究 被引量:1
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作者 龚时国 谢荣辉 +1 位作者 汪建样 刘牧子 《中国骨伤》 CAS CSCD 2024年第7期655-663,共9页
目的:探讨关节镜下测量关节腔内移植物长度在前交叉韧带(anterior cruciate ligament,ACL)全内重建应用的临床疗效。方法:回顾性分析2020年1月至2022年1月收治的ACL损伤患者60例的资料,其中男37例,女23例,年龄22~44岁。按照手术方式的不... 目的:探讨关节镜下测量关节腔内移植物长度在前交叉韧带(anterior cruciate ligament,ACL)全内重建应用的临床疗效。方法:回顾性分析2020年1月至2022年1月收治的ACL损伤患者60例的资料,其中男37例,女23例,年龄22~44岁。按照手术方式的不同,分为传统手术组(常规组)和拉线测量组(测量组),每组各30例。常规组男20例,女10例,年龄(30.00±3.95)岁;身体质量指数(body mass index,BMI)为(22.58±1.41)kg·m^(-2);左侧9例,右侧21例;受伤至手术时间(3.00±1.35)d。测量组男17例,女13例,年龄(32.00±4.29)岁;BMI为(23.29±1.39)kg·m^(-2);左侧12例,右侧18例;受伤至手术时间(3.00±1.27)d。记录患者术前及术后6、12个月的临床资料。从术后视觉模拟评分法(visual analogue scale,VAS)、膝关节损伤与骨关节炎评分(knee injury and osteoarthritis outcome score,KOOS)、Lysholm评分、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)膝关节评估表、膝关节稳定性(Lachman试验、前抽屉试验和轴移试验)、术后不同阶段CT测量骨隧道直径增宽程度和MRI评分系统等方面比较两种方法的临床疗效。结果:术后6个月两组VAS比较差异无统计学意义(P>0.05),术后12个月测量组VAS(2.23±1.01)分,低于常规组(3.30±1.02)分(P<0.001)。术后12个月,两组KOOS评分除症状评分差异无统计学意义(P=0.221),其余各项评分差异均有统计学意义(P<0.05)。术后6个月,测量组Lysholm总分和IKDC总分均高于常规组(P<0.05)。术后12个月,测量组Lachman试验、前抽屉试验和轴移试验和常规组比较,差异均无统计学意义(P>0.05);但是,整体膝关节不稳定性分析,测量组膝关节稳定性优于对照组(P=0.038)。术后2 d及术后6、12个月两组患者影像学评估结果显示,测量组股骨和胫骨的肌腱隧道直径增宽程度均较常规组术后减少(P<0.05);MRI评分测量组患者均高于常规组(P<0.05)。结论:关节镜下测量关节腔内移植物长度在全内技术ACL重建,肌腱利用率高,稳定性好,1年内膝关节功能恢复满意,疗效肯定。 展开更多
关键词 关节镜 前交叉韧带重建 拉线法 关节内移植物长度
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膝关节软骨退变损伤的生物力学研究进展
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作者 韩金昌 穆世茵 +4 位作者 刘爱峰 张晓宇 张超 孟涛 符碧峰 《河北医药》 CAS 2024年第12期1859-1864,共6页
膝关节是结构复杂的滑膜关节,软骨覆盖于关节表面,具有缓冲压力及减轻震荡等作用。关节软骨具有多种力学特性,受应力强度、持续时间及频率等因素影响,软骨退变损伤是个复杂的过程,从生物力学角度而言,就是异常应力超出了软骨的适应能力... 膝关节是结构复杂的滑膜关节,软骨覆盖于关节表面,具有缓冲压力及减轻震荡等作用。关节软骨具有多种力学特性,受应力强度、持续时间及频率等因素影响,软骨退变损伤是个复杂的过程,从生物力学角度而言,就是异常应力超出了软骨的适应能力,进而引起软骨成分及微结构等改变。因此,生物力学因素在软骨退变损伤的进程及机制中发挥重要作用,并对软骨修复具有重要意义。综述膝关节软骨力学性能的相关研究文献,阐述软骨的生物力学特性、退变损伤过程以及生物力学因素在软骨退变损伤、修复过程中的作用及机制,为膝关节软骨相关疾病的病程发展、预防及治疗提供理论依据。 展开更多
关键词 关节软骨 退变损伤 软骨修复 生物力学
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关节镜下桡尺远侧韧带重建治疗慢性PalmerⅠD型三角纤维软骨复合体损伤疗效观察
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作者 杨顺 程亚博 +3 位作者 向往 张静 陈柯屹 虞亚明 《中国运动医学杂志》 CAS CSCD 北大核心 2024年第7期512-517,共6页
目的:探讨腕关节镜辅助下异体肌腱重建桡尺远侧韧带治疗慢性PalmerⅠD型三角纤维软骨复合体损伤伴桡尺远侧关节不稳的临床疗效。方法:回顾性分析我院2017年1月至2020年1月收治的15例慢性PalmerⅠD型三角纤维软骨复合体损伤患者临床资料... 目的:探讨腕关节镜辅助下异体肌腱重建桡尺远侧韧带治疗慢性PalmerⅠD型三角纤维软骨复合体损伤伴桡尺远侧关节不稳的临床疗效。方法:回顾性分析我院2017年1月至2020年1月收治的15例慢性PalmerⅠD型三角纤维软骨复合体损伤患者临床资料,均给予腕关节镜辅助下异体肌腱重建桡尺远侧韧带治疗,术后随访并评价腕关节的活动度、腕关节疼痛视觉模拟评分(VAS评分)、握力、腕关节功能评分(改良Mayo评分)。结果:所有患者术后随访12~24个月,平均18.15±2.20个月。术后15例患者腕关节疼痛VAS评分为2.56±0.69分,与术前的6.78±1.24分比较差异有统计学意义(P<0.05),疼痛显著缓解。术后患侧手和健侧手的握力比率为(76.18±9.72)%,与术前的(50.18±6.79)%比较差异具有统计学意义(P<0.05),握力显著增大。术后腕关节旋转活动度为(151.09±12.38)°,较术前的(142.87±10.19)°有显著改善,差异有统计学意义(P<0.05)。按照改良Mayo评分,优8例,良6例,可1例,优良率为93.33%。结论:腕关节镜辅助下异体肌腱重建桡尺远侧韧带治疗慢性PalmerⅠD型三角纤维软骨复合体损伤伴桡尺远侧关节不稳疗效确切,可促进疼痛、握力、旋转活动度的改善。 展开更多
关键词 三角纤维软骨复合体损伤 腕关节镜 韧带重建
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前交叉韧带重建术后三种不同药物镇痛早期疗效的对比
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作者 王江静 魏顺依 +1 位作者 敖英芳 杨渝平 《北京大学学报(医学版)》 CAS CSCD 北大核心 2024年第2期293-298,共6页
目的:比较去痛片(复方氨基比林、非那西丁片,商品名去痛片)、盐酸曲马多缓释片(商品名:奇曼丁)及盐酸哌替啶(商品名:杜冷丁)在膝关节前交叉韧带自体肌腱单束重建术后早期的止疼效果及安全性。方法:回顾性分析2018年11月至2019年2月,北... 目的:比较去痛片(复方氨基比林、非那西丁片,商品名去痛片)、盐酸曲马多缓释片(商品名:奇曼丁)及盐酸哌替啶(商品名:杜冷丁)在膝关节前交叉韧带自体肌腱单束重建术后早期的止疼效果及安全性。方法:回顾性分析2018年11月至2019年2月,北京大学第三医院连续收治的45例由同一组医师施行膝关节镜下前交叉韧带自体肌腱单束重建术患者,术后疼痛情况和使用药物镇痛情况的临床资料。采用随机区组设计,根据前交叉韧带断裂是否合并半月板损伤将患者分为两组,A组为单纯膝关节前交叉韧带重建的患者24例,B组为前交叉韧带断裂合并半月板损伤的患者21例。两组又根据患者实际使用的术后镇痛药物各分为3组,其中,A组口服去痛片4例、口服奇曼丁11例、肌肉注射(简称肌注)杜冷丁联合盐酸异丙嗪(商品名:非那根)9例;B组口服去痛片3例、口服奇曼丁10例、肌注杜冷丁联合非那根8例。术后早期,患者诉疼痛并主动要求镇痛时随机给予去痛片、奇曼丁或杜冷丁联合非那根这三种不同的止痛药物缓解疼痛,采用疼痛视觉模拟评分(visual analogue scale, VAS)评估疼痛缓解情况,并观察不良反应发生情况。结果:患者在性别、年龄、体重指数、住院时间等基本情况上差异无统计学意义(P>0.05)。应用三种止痛药物缓解疼痛的两组患者,在用药前及用药1 h后通过VAS评分判断结果表明,患者疼痛情况明显缓解,用药前后疼痛差异有统计学意义(P<0.05)。对两组患者应用的三种药物进行两两比较显示,杜冷丁联合非那根组对于疼痛缓解的程度显著高于其余两种药物(P<0.05),用药1 h后,两组差异无统计学意义(P>0.05)。应用杜冷丁患者易出现恶心、呕吐等副反应,但应用杜冷丁的同时使用非那根可减少副反应。在不良反应方面,仅单纯前交叉韧带重建组中应用奇曼丁组的患者出现恶心1例,其余各组患者均未出现严重的并发症及过敏反应。结论:无论是单纯交叉韧带重建,还是合并半月板成型或缝合的交叉韧带重建,患者应用去痛片、奇曼丁、杜冷丁联合非那根这三种药物均能有效缓解疼痛,其中杜冷丁对疼痛的缓解幅度最大。应用杜冷丁的同时,合用非那根可有效减轻患者的呕吐、恶心等不良反应,增加用药安全性。 展开更多
关键词 前交叉韧带重建 半月板损伤 镇痛 镇痛药 阿片类
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前交叉韧带重建后肌肉等长发力率及与功能表现的关系 被引量:1
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作者 李奇 高明威 +4 位作者 李世浩 褚晓蕾 李亚杰 丁宁 刘敏琦 《中国组织工程研究》 CAS 北大核心 2024年第34期5536-5543,共8页
背景:前交叉韧带重建后肌肉功能的恢复通常评估肌肉的最大力量,最近的研究认为还应考虑神经肌肉功能,比如肌肉等长发力率,即在肌肉等长收缩条件下测量不同时间间隔的力-时间曲线斜率。目的:阐述前交叉韧带重建后患者肌肉等长发力率的研... 背景:前交叉韧带重建后肌肉功能的恢复通常评估肌肉的最大力量,最近的研究认为还应考虑神经肌肉功能,比如肌肉等长发力率,即在肌肉等长收缩条件下测量不同时间间隔的力-时间曲线斜率。目的:阐述前交叉韧带重建后患者肌肉等长发力率的研究现状与不足,分析术后不同时间内股四头肌和腘绳肌等长发力率的缺陷程度;等长发力率对术后患者功能表现的影响,为优化前交叉韧带重建后康复、减少患者二次损伤以及降低膝骨关节炎发生率提供重要信息。方法:检索中国知网、维普、万方和PubMed数据库,以“前交叉韧带,发力率”为中文检索词,以“anterior cruciate ligament,rate of force development,rate of torque development”为英文检索词,按照纳入和排除标准最终纳入69篇文献。结果与结论:(1)大多数研究发现前交叉韧带重建后半年内患者双侧肌肉等长发力率存在缺陷,双侧腘绳肌早期等长发力率(即肌肉收缩100 ms时间段内任意时间间隔的力-时间曲线斜率)在半年后有显著改善,但双侧股四头肌早期等长发力率长期缺陷,表明术后股四头肌神经肌肉功能长期受损。(2)有关晚期等长发力率(肌肉收缩100 ms后时间段内任意时间间隔的力-时间曲线斜率)的相关研究较少,无法得出确切结论。(3)关于着陆运动(跳跃落地和侧切等)和日常生活活动(走、跑),股四头肌早期等长发力率比等长峰值力矩相关性更强,运动过程中生物力学的异常改变被认为是患者二次损伤以及创伤性膝骨关节炎发生的重要风险因素,积极改善股四头肌早期等长发力率可能会降低二次损伤以及创伤性膝骨关节炎的发生率。(4)目前仅有很少的证据表明,全身振动训练能改善前交叉韧带重建后患者股四头肌早期等长发力率,建议今后在术后早期阶段应用神经肌肉电刺激干预股四头肌和腘绳肌,而在术后晚期阶段实施爆发力、高阻力训练,这可能会改善患者等长发力率。(5)短时间产生足够的肌肉力量才能有效保护前交叉韧带,而腘绳肌等长发力率与功能表现的关系尚不清楚,这可能会提供有关预防患者二次损伤的信息。(6)作者建议将等长发力率作为指导康复以及恢复运动的评估指标之一,除了关注对称性的改善以及与正常人的差异,还要考虑腘绳肌与股四头肌力量的比值,合适的比值范围才能保证肌肉快速发力时的平衡,这可能会降低再次损伤的发生,但比值的正常范围尚不清楚。(7)未来研究要考虑移植物类型和膝关节屈曲角度对等长发力率的影响,以尽可能找出患者存在的神经肌肉功能障碍,帮助患者更好地康复。 展开更多
关键词 发力率 等长收缩 前交叉韧带重建 神经肌肉功能 功能表现 二次损伤 股四头肌 综述
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MSCT和MRI在膝关节半月板、关节软骨损伤诊断及分期评估中的应用
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作者 陈真 姚龙 冯天保 《川北医学院学报》 CAS 2024年第7期900-903,共4页
目的:探讨多层螺旋CT(MSCT)与磁共振成像(MRI)在膝关节半月板及关节软骨损伤(MACI)诊断及分期评估中的价值。方法:对97例均接受MSCT、MRI检查的MACI患者的临床资料进行回顾性分析,金标准为关节镜诊断结果,分析MSCT、MRI的诊断效能。结果... 目的:探讨多层螺旋CT(MSCT)与磁共振成像(MRI)在膝关节半月板及关节软骨损伤(MACI)诊断及分期评估中的价值。方法:对97例均接受MSCT、MRI检查的MACI患者的临床资料进行回顾性分析,金标准为关节镜诊断结果,分析MSCT、MRI的诊断效能。结果:关节镜诊断结果显示,97例患者的194个半月板中,损伤103个,未损伤91个;97例患者存在582个关节软骨面,其中损伤284个,未损伤298个;MSCT诊断结果显示,97例患者存在194个半月板,损伤106个,未损伤88个;MRI诊断结果显示,97例患者存在194个半月板,损伤109个,未损伤85个。MRI诊断膝关节半月板损伤和软骨关节损伤的准确度、特异度及敏感度均高于MSCT(P<0.05);MRI对半月板损伤分级和软骨关节损伤分期的诊断准确率高于MSCT。结论:MRI在MACI诊断中的价值优于MSCT,能准确反映损伤严重程度。 展开更多
关键词 膝关节半月板 磁共振成像 多层螺旋CT 关节软骨损伤
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带线锚钉修补踝关节骨折合并三角韧带损伤的疗效
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作者 韦志坤 邵菲 +2 位作者 王旭东 杨金杰 范小波 《局解手术学杂志》 2024年第8期713-717,共5页
目的探究带线锚钉(SA)修补联合切开复位内固定术(ORIF)对踝关节骨折(AF)合并三角韧带损伤(DLI)患者的疗效。方法选择2020年1月至2022年9月我院收治的138例AF合并DLI患者,按照随机数字表法分为对照组(69例)和观察组(69例)。对照组患者采... 目的探究带线锚钉(SA)修补联合切开复位内固定术(ORIF)对踝关节骨折(AF)合并三角韧带损伤(DLI)患者的疗效。方法选择2020年1月至2022年9月我院收治的138例AF合并DLI患者,按照随机数字表法分为对照组(69例)和观察组(69例)。对照组患者采用ORIF治疗,观察组患者在对照组的基础上进行SA修补治疗。比较2组患者的临床疗效,治疗前及治疗后3个月的美国矫形足踝外科协会(AOFAS)评分、视觉模拟量表(VAS)评分、距骨倾斜角、患侧内踝间隙、骨代谢指标[血清骨钙素(BGP)、β胶原降解产物(β-CTX)]水平及并发症的发生率。结果观察组患者的总有效率高于对照组,差异有统计学意义(P<0.05)。与治疗前比较,2组患者治疗后3个月的距骨倾斜角、患侧内踝间隙、VAS评分、β-CTX水平减小/降低,AOFAS评分、BGP水平升高,差异均有统计学意义(P<0.05);观察组患者治疗后AOFAS评分、BGP水平高于对照组,距骨倾斜角、患侧内踝间隙小于对照组,VAS评分、β-CTX水平低于对照组,差异均有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论SA修补对AF合并DLI患者的治疗效果确切,可改善患者症状,促进踝关节功能及骨代谢恢复。 展开更多
关键词 带线锚钉修补 踝关节骨折 三角韧带损伤 距骨倾斜角 踝关节功能
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带线锚钉修复与改良开放式Brostr?m修复对慢性踝关节不稳距腓前韧带损伤患者术后踝关节功能的影响
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作者 缪小兵 顾本进 +2 位作者 崔益华 张君 冯素娟 《中南医学科学杂志》 CAS 2024年第5期835-838,共4页
目的 探究带线锚钉修复与改良开放式Brostr9m修复对慢性踝关节不稳距腓前韧带(ATFL)损伤患者术后踝关节功能的影响。方法 选取慢性踝关节不稳ATFL损伤患者80例,依据治疗方法不同,采用带线锚钉修复的43例为锚钉组,采用改良开放式Brostr9... 目的 探究带线锚钉修复与改良开放式Brostr9m修复对慢性踝关节不稳距腓前韧带(ATFL)损伤患者术后踝关节功能的影响。方法 选取慢性踝关节不稳ATFL损伤患者80例,依据治疗方法不同,采用带线锚钉修复的43例为锚钉组,采用改良开放式Brostr9m修复的37例为Brostr9m组。比较两组围手术期指标、疼痛情况(术前、术后1周、术后1个月、术后3个月和术后1年)、足踝功能和踝关节活动度(术前、术后1年),记录并发症情况。结果 锚钉组可负重时间和重返运动时间均低于Brostr9m组(P<0.05);术后1周、术后1个月、术后3个月、术后1年,两组疼痛VAS评分均较术前逐渐呈递减趋势降低(P<0.05),锚钉组术后1周、术后1个月低于Brostr9m组(P<0.05);术后1年,两组AOFAS足踝量表评分、Tegner评分和Kofoed踝关节功能评分均较术前提高,且锚钉组高于Brostr9m组(P<0.05);两组背屈角度和跖屈角度均较术前提升,距骨倾斜度和距骨前移度均较术前降低,且两组间差异有统计学意义(P<0.05);锚钉组并发症总发生率低于Brostr9m组(P<0.05)。结论 带线锚钉修复对ATFL缓解疼痛、改善踝关节功能和活动度、促进康复进程及减少术后并发症方面较改良开放式Brostr9m修复更有优势。 展开更多
关键词 踝关节不稳 距腓前韧带损伤 带线锚钉修复 改良开放式Brostr9m修复 踝关节功能 康复
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两种股骨隧道技术在前交叉韧带全内重建中的疗效比较
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作者 张军 朱伟伟 +2 位作者 徐付国 赵一朗 王涛 《实用骨科杂志》 2024年第9期793-797,共5页
目的比较关节镜下前交叉韧带(anterior cruciate ligament,ACL)全内重建中,由外向内技术和经前内侧入路技术制作股骨隧道对术后临床疗效的差异。方法收集2020年2月至2022年6月徐州市中心医院运动医学科收治的60例ACL断裂患者,根据手术... 目的比较关节镜下前交叉韧带(anterior cruciate ligament,ACL)全内重建中,由外向内技术和经前内侧入路技术制作股骨隧道对术后临床疗效的差异。方法收集2020年2月至2022年6月徐州市中心医院运动医学科收治的60例ACL断裂患者,根据手术技术的不同,分为观察组(由外向内技术)30例和对照组(经前内侧入路技术)30例。其中观察组男20例,女10例;年龄24~37岁,平均(29.30±4.00)岁;对照组男17例,女13例;年龄23~40岁,平均(29.70±4.21)岁;比较两组患者术前、术后6个月、12个月膝关节Lysholm评分和美国膝关节协会评分(knee society score,KSS);比较两组患者术前和末次随访膝关节松弛度;随访期间记录两组患者伤口感染、肌腱松动、术后再次翻修等情况。结果所有患者均获随访,随访时间12~18个月,观察组平均随访(15.37±1.61)个月,对照组平均随访(14.97±1.56)个月;术后12个月,观察组膝关节前抽屉试验、Lachman试验和轴移试验结果与对照组患者相似,差异无统计学意义(P>0.05);术后6个月和12个月两组患者膝关节Lysholm评分和KSS评分相似,差异无统计学意义(P>0.05);随访期间,两组患者均未发生伤口感染、肌腱松动、术后再次翻修等情况。结论ACL全内重建中,选择经前内侧入路技术或由外向内技术制作股骨隧道均能实现股骨隧道的解剖定位,术后两组患者膝关节功能恢复良好,短期疗效均可接受。 展开更多
关键词 前交叉韧带 损伤 全内重建技术 经前内侧入路技术
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MR检查在踝关节不同体位下对周围韧带和肌腱损伤的诊断价值研究
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作者 周祺源 杨俊霞 +1 位作者 詹浩辉 程鹏 《临床研究》 2024年第6期124-126,共3页
目的分析磁共振(MRI)检查在踝关节不同体位下对周围韧带和肌腱损伤的诊断价值。方法选择2021年1月至2023年7月河南科技大学第二附属医院收治的76例踝关节扭伤/骨折患者作为此次研究对象,纳入研究患者均接受MRI检查(分不同体位检查:自然... 目的分析磁共振(MRI)检查在踝关节不同体位下对周围韧带和肌腱损伤的诊断价值。方法选择2021年1月至2023年7月河南科技大学第二附属医院收治的76例踝关节扭伤/骨折患者作为此次研究对象,纳入研究患者均接受MRI检查(分不同体位检查:自然体位、完全跖屈、完全背屈)。对比不同体位下踝骨内侧、外侧MRI T_(2)值;另外将MRI检查与手术结果进行对照,对其诊断结果及阳性征象检出率进行分析比较。结果自然体位、完全跖屈、完全背屈踝骨内外侧负重区、非负重区MRI T_(2)指对比差异无统计学差异(P>0.05);经手术发现阳性70例,阴性6例,自然体位MRI检查诊断阳性68例,阴性8例,完全跖屈MRI检查诊断阳性67例,阴性9例,完全背屈MRI检查诊断阳性65例,阴性11例。自然体位MRI检查诊断准确度、灵敏度及特异度分别为94.74%、95.71%、83.33%,完全跖屈MRI检查诊断准确度、灵敏度及特异度分别为90.79%、92.86%、66.67%;完全背屈MRI检查诊断准确度、灵敏度及特异度分别为90.79%、91.43%、83.33%,三种体位MRI诊断效能对比差异无统计学意义(P>0.05)。结论MRI能较准确的评估踝扭伤/骨折患者的踝关节稳定性,在踝关节3种体位下(自然体位、完全跖屈、完全背屈)均能较敏感的反映周围韧带和肌腱损伤情况。 展开更多
关键词 MRI检查 踝关节 韧带损伤 肌腱损伤 诊断效能
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