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
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
目的:对慢性踝关节不稳合并后踝撞击综合征患者术后进行3~9年的随访,探讨其中长期疗效,并对其影响因素进行分析。方法: 2010年2月—2015年12月于北京大学第三医院运动医学研究所接受外踝韧带修复和后踝关节镜清理同期手术的患者共47例,...目的:对慢性踝关节不稳合并后踝撞击综合征患者术后进行3~9年的随访,探讨其中长期疗效,并对其影响因素进行分析。方法: 2010年2月—2015年12月于北京大学第三医院运动医学研究所接受外踝韧带修复和后踝关节镜清理同期手术的患者共47例,随访42例,其中男性26例、女性16例,平均年龄(28.9±10.0)岁。通过问卷及查体记录患者的临床症状、关节稳定性、活动度及运动机能等,对比术前和术后疼痛视觉模拟评分(visual analogue scale,VAS)、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)后足评分、运动机能Tegner评分,并分析临床评分与患者年龄、性别、身高、体重指数、受伤时间、手术用时、软骨损伤等因素的相关性。结果:平均随访时间为(71.8±22.8)个月。患者术后VAS评分、AOFAS评分及Tegner评分均优于术前水平( 1.0 vs. 5.0, 92 vs. 80, 6.5 vs. 2.0, P 均<0.001),疗效优良率为97.6%,术后VAS评分( t =2.719, P =0.10)、AOFAS评分( t =-2.853, P =0.10)、Tegner评分( t =-3.443, P =0.001)和恢复运动时间( t =2.814, P =0.008)均与患者年龄呈负相关,术后VAS评分与软骨损伤呈负相关( Z =-2.195, P =0.028)。结论:慢性踝关节不稳合并后踝撞击同期手术后的中长期临床效果良好,患者年龄与临床疗效呈负相关,合并软骨损伤可加重患者术后疼痛。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.
文摘目的:对慢性踝关节不稳合并后踝撞击综合征患者术后进行3~9年的随访,探讨其中长期疗效,并对其影响因素进行分析。方法: 2010年2月—2015年12月于北京大学第三医院运动医学研究所接受外踝韧带修复和后踝关节镜清理同期手术的患者共47例,随访42例,其中男性26例、女性16例,平均年龄(28.9±10.0)岁。通过问卷及查体记录患者的临床症状、关节稳定性、活动度及运动机能等,对比术前和术后疼痛视觉模拟评分(visual analogue scale,VAS)、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)后足评分、运动机能Tegner评分,并分析临床评分与患者年龄、性别、身高、体重指数、受伤时间、手术用时、软骨损伤等因素的相关性。结果:平均随访时间为(71.8±22.8)个月。患者术后VAS评分、AOFAS评分及Tegner评分均优于术前水平( 1.0 vs. 5.0, 92 vs. 80, 6.5 vs. 2.0, P 均<0.001),疗效优良率为97.6%,术后VAS评分( t =2.719, P =0.10)、AOFAS评分( t =-2.853, P =0.10)、Tegner评分( t =-3.443, P =0.001)和恢复运动时间( t =2.814, P =0.008)均与患者年龄呈负相关,术后VAS评分与软骨损伤呈负相关( Z =-2.195, P =0.028)。结论:慢性踝关节不稳合并后踝撞击同期手术后的中长期临床效果良好,患者年龄与临床疗效呈负相关,合并软骨损伤可加重患者术后疼痛。
