AIM To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone(BTB) autografts, and to clarify the influence of tu...AIM To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone(BTB) autografts, and to clarify the influence of tunnel positions on the knee stability.METHODS Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial(TT)(n = 20) and trans-portal(TP)(n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3 D-CT bone models two weeks after surgery. Anterolateral rotatory translation was examined using a Slocum anterolateral rotatory instability test in open magnetic resonance imaging(MRI) 1.0-1.5 years after surgery, by measuring anterior tibial translation at the medial and lateral compartments on its sagittal images. Anterior-posterior stability was evaluated with a Kneelax3 arthrometer.RESULTS A total of 40 patients(80%) were finally followed up. Femoral tunnel positions were shallower(P < 0.01) and higher(P < 0.001), and tibial tunnel positions were more posterior(P < 0.05) in the TT group compared with the TP group. Anterolateral rotatory translations in reconstructed knees were significantly correlated with the shallow femoral tunnel positions(R = 0.42, P < 0.01), and the rotatory translations were greater in the TT group(3.2 ± 1.6 mm) than in the TP group(2.0 ± 1.8 mm)(P < 0.05). Side-to-side differences of Kneelax3 arthrometer were 1.5 ± 1.3 mm in the TT, and 1.7 ± 1.6 mm in the TP group(N.S.). Lysholm scores, KOOS subscales and reinjury rate showed no difference between the two groups.CONCLUSION Anterolateral rotatory instability significantly correlated shallow femoral tunnel positions after ACL reconstruction using BTB autografts. Clinical outcomes, rotatory and anterior-posterior stability were overall satisfactory in both techniques, but the TT technique located femoral tunnels in shallower and higher positions, and tibial tunnels in more posterior positions than the TP technique, thus increased the anterolateral rotation. Anatomic ACL reconstruction with BTB autografts may restore knee function and stability.展开更多
Objective:To observe the effect of the treatment of tendon-regulation and bone-setting manipulation and Kinesio Taping on patients with de Quervain Disease.Methods:60 cases with de Quervain Disease were divided into 3...Objective:To observe the effect of the treatment of tendon-regulation and bone-setting manipulation and Kinesio Taping on patients with de Quervain Disease.Methods:60 cases with de Quervain Disease were divided into 30 treatment group and 30 control group according to random number table.The observation group was treated withtendon-regulation and bone-setting manipulation and Kinesio Taping,and the control group was given Votalin emulsion combined with Kinesio Taping.The patients were evaluated and compared according to the VAS before and after treatment,the degree of tenderness,the methods of electric integral value(integral electromyogram,iEMG),the degree of wrist ulnar deviation,and the cooney wrist score,and the curative effect was observed using the diagnostic curative effect criteria of TCM disease(the evaluation process was blinded).Results:Compared with the same group before treatment,after treatment,the pain and tenderness of the two groups were reduced,iEMG value increased,the ulnar deviation of the wrist increased,and the cooney wrist score increased(all P<0.05);the improvement of the treatment group was significantly better.In the control group,the difference was statistically significant(P<0.05)and the total effective rate of the treatment group was 93%higher than that of the control group 80%(P<0.05).Conclusion:The combination of the tendon-regulation and bone-setting manipulation combined with the Kinesio Taping can effectively reduce the pain and tenderness of the patients withde Quervain Disease,increase the ulnar mobility of the wrist joint,and improve the joint function of the wrist joint.展开更多
背景:随着肌腱损伤肌腱移植手术的增多,对肌腱组织工程支架的需求日益增加,研究发现植入物良好的孔隙大小及孔隙率有助于组织愈合。目的:总结肌腱组织工程支架的材料种类,调查各类肌腱组织工程支架材料与孔隙的相关情况。方法:应用计算...背景:随着肌腱损伤肌腱移植手术的增多,对肌腱组织工程支架的需求日益增加,研究发现植入物良好的孔隙大小及孔隙率有助于组织愈合。目的:总结肌腱组织工程支架的材料种类,调查各类肌腱组织工程支架材料与孔隙的相关情况。方法:应用计算机检索PubMed、Embase、Web of Science数据库中发表的相关文献,检索关键词为“tendon”或“ligament”和“tissue scaffold”以及“porosity”或“permeability”,共纳入84篇符合标准的文献进行归纳总结,讨论并展望未来的发展方向。结果与结论:肌腱组织工程研究所涉及的支架材料主要分为天然肌腱支架材料和人工合成腱性支架材料两大类,其中天然支架材料包含自体肌腱、同种异体肌腱和异种肌腱,自体肌腱、同种异体肌腱在临床上已应用多年,在制备异体肌腱以及动物实验过程中发现脱细胞消毒过程中会导致两种肌腱孔隙大小及孔隙率增加的现象,但是具体原因及机制并未进一步研究。人工合成腱性支架材料目前研究的种类有很多,其中以Leeds Keio、LARS为代表的人工韧带产品目前还在部分国家使用,其他材料目前因技术不成熟等问题未能在临床推广,人工合成腱性支架材料的孔隙及孔隙率因其材料与制备技术的不同也呈现不同的趋势。展开更多
基金Supported by JSPS Fellowships for Research Abroad,No.H27-787International Research Fund for Subsidy of Kyushu University School of Medicine Alumni
文摘AIM To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone(BTB) autografts, and to clarify the influence of tunnel positions on the knee stability.METHODS Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial(TT)(n = 20) and trans-portal(TP)(n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3 D-CT bone models two weeks after surgery. Anterolateral rotatory translation was examined using a Slocum anterolateral rotatory instability test in open magnetic resonance imaging(MRI) 1.0-1.5 years after surgery, by measuring anterior tibial translation at the medial and lateral compartments on its sagittal images. Anterior-posterior stability was evaluated with a Kneelax3 arthrometer.RESULTS A total of 40 patients(80%) were finally followed up. Femoral tunnel positions were shallower(P < 0.01) and higher(P < 0.001), and tibial tunnel positions were more posterior(P < 0.05) in the TT group compared with the TP group. Anterolateral rotatory translations in reconstructed knees were significantly correlated with the shallow femoral tunnel positions(R = 0.42, P < 0.01), and the rotatory translations were greater in the TT group(3.2 ± 1.6 mm) than in the TP group(2.0 ± 1.8 mm)(P < 0.05). Side-to-side differences of Kneelax3 arthrometer were 1.5 ± 1.3 mm in the TT, and 1.7 ± 1.6 mm in the TP group(N.S.). Lysholm scores, KOOS subscales and reinjury rate showed no difference between the two groups.CONCLUSION Anterolateral rotatory instability significantly correlated shallow femoral tunnel positions after ACL reconstruction using BTB autografts. Clinical outcomes, rotatory and anterior-posterior stability were overall satisfactory in both techniques, but the TT technique located femoral tunnels in shallower and higher positions, and tibial tunnels in more posterior positions than the TP technique, thus increased the anterolateral rotation. Anatomic ACL reconstruction with BTB autografts may restore knee function and stability.
基金Key project of the Natural Foundation of the Department of Education of Anhui Province(No.KJ2018A0273)。
文摘Objective:To observe the effect of the treatment of tendon-regulation and bone-setting manipulation and Kinesio Taping on patients with de Quervain Disease.Methods:60 cases with de Quervain Disease were divided into 30 treatment group and 30 control group according to random number table.The observation group was treated withtendon-regulation and bone-setting manipulation and Kinesio Taping,and the control group was given Votalin emulsion combined with Kinesio Taping.The patients were evaluated and compared according to the VAS before and after treatment,the degree of tenderness,the methods of electric integral value(integral electromyogram,iEMG),the degree of wrist ulnar deviation,and the cooney wrist score,and the curative effect was observed using the diagnostic curative effect criteria of TCM disease(the evaluation process was blinded).Results:Compared with the same group before treatment,after treatment,the pain and tenderness of the two groups were reduced,iEMG value increased,the ulnar deviation of the wrist increased,and the cooney wrist score increased(all P<0.05);the improvement of the treatment group was significantly better.In the control group,the difference was statistically significant(P<0.05)and the total effective rate of the treatment group was 93%higher than that of the control group 80%(P<0.05).Conclusion:The combination of the tendon-regulation and bone-setting manipulation combined with the Kinesio Taping can effectively reduce the pain and tenderness of the patients withde Quervain Disease,increase the ulnar mobility of the wrist joint,and improve the joint function of the wrist joint.
文摘背景:随着肌腱损伤肌腱移植手术的增多,对肌腱组织工程支架的需求日益增加,研究发现植入物良好的孔隙大小及孔隙率有助于组织愈合。目的:总结肌腱组织工程支架的材料种类,调查各类肌腱组织工程支架材料与孔隙的相关情况。方法:应用计算机检索PubMed、Embase、Web of Science数据库中发表的相关文献,检索关键词为“tendon”或“ligament”和“tissue scaffold”以及“porosity”或“permeability”,共纳入84篇符合标准的文献进行归纳总结,讨论并展望未来的发展方向。结果与结论:肌腱组织工程研究所涉及的支架材料主要分为天然肌腱支架材料和人工合成腱性支架材料两大类,其中天然支架材料包含自体肌腱、同种异体肌腱和异种肌腱,自体肌腱、同种异体肌腱在临床上已应用多年,在制备异体肌腱以及动物实验过程中发现脱细胞消毒过程中会导致两种肌腱孔隙大小及孔隙率增加的现象,但是具体原因及机制并未进一步研究。人工合成腱性支架材料目前研究的种类有很多,其中以Leeds Keio、LARS为代表的人工韧带产品目前还在部分国家使用,其他材料目前因技术不成熟等问题未能在临床推广,人工合成腱性支架材料的孔隙及孔隙率因其材料与制备技术的不同也呈现不同的趋势。
