BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,...BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,which may increase the risk of morbidity.In response to these concerns,arthroscopic techniques have been evolving.The aim of this study was to introduce a modified arthroscopic tech-nique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series.AIM To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL.METHODS We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL.This case series included 18 patients who underwent the procedure between January 2021 and December 2022.The patients were assessed for range of motion(ROM),Lysholm score and International knee documentation committee(IKDC)score.Postoperative complications were also recorded.RESULTS The patients were followed for a mean of 13.83±2.33 months.All patients showed radiographic union.At the final follow-up,all patients had full ROM and a negative posterior drawer test.The mean Lysholm score significantly improved from 45.28±8.92 preoperatively to 91.83±4.18 at the final follow-up(P<0.001),and the mean IKDC score improved from 41.98±6.06 preoperatively to 90.89±5.32 at the final follow-up(P<0.001).CONCLUSION The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL,with excellent fracture healing and functional recovery.展开更多
背景:治疗后交叉韧带胫骨附着点撕脱骨折的最佳手术技术仍值得商榷。随着关节镜手术的应用与成熟,它在后交叉韧带胫骨附着点撕脱骨折的诊疗中有很大前景。目的:综述关节镜技术在后交叉韧带胫骨附着点撕脱骨折治疗中的应用与进展,包括不...背景:治疗后交叉韧带胫骨附着点撕脱骨折的最佳手术技术仍值得商榷。随着关节镜手术的应用与成熟,它在后交叉韧带胫骨附着点撕脱骨折的诊疗中有很大前景。目的:综述关节镜技术在后交叉韧带胫骨附着点撕脱骨折治疗中的应用与进展,包括不同关节镜治疗方法、手术入路、胫骨隧道设计、缝合材料选择以及内固定植入物选择等。方法:通过计算机对中国知网、PubMed、Web of Science及ScienceDirect等数据库中的相关文献进行检索,检索时间为2003年1月至2023年11月,中文检索词为“后交叉韧带,后十字韧带,撕脱骨折,关节镜”;英文检索词为“posterior cruciate ligament,avulsion,fracture,tibia,arthroscopic,operation,fixation,treatment”。共纳入97篇文献进行综述。结果与结论:关节镜技术提供了一种可靠的治疗方式来治疗后交叉韧带胫骨附着点撕脱骨折。根据入路、缝合材料类型以及用于缝合的入路和胫骨隧道数量等不同,关节镜技术可以分为关节镜下缝线固定结合自体移植物增强重建、关节镜下多交叉带缝合桥固定、关节镜下高强度缝线固定以及关节镜下直接前后缝合悬吊固定等几类。在各种研究中,常用的临床结果评估指标包括关节活动度、Lysholm评分、国际膝关节文献委员会评分及KT-2000关节测量仪差等,研究显示关节镜手术后末次随访时上述指标检测结果较术前显著改善,影像学随访结果显示关节镜手术都取得了令人满意的结果。在随访过程中,接受关节镜技术治疗后的各类交叉韧带胫骨附着点撕脱骨折患者都未出现严重并发症,例如创伤性关节炎、神经血管损伤、围手术期伤口感染、血栓形成以及骨折不愈合等。展开更多
目的探讨关节镜下治疗不同肩肱距离(acromiohumeral distance,AHD)的大型和巨大肩袖撕裂的临床疗效。方法回顾性分析2018年1月至2022年6月于徐州医科大学附属医院骨科接受关节镜治疗的125例大型和巨大肩袖撕裂患者的临床资料。根据AHD...目的探讨关节镜下治疗不同肩肱距离(acromiohumeral distance,AHD)的大型和巨大肩袖撕裂的临床疗效。方法回顾性分析2018年1月至2022年6月于徐州医科大学附属医院骨科接受关节镜治疗的125例大型和巨大肩袖撕裂患者的临床资料。根据AHD不同分为2组,AHD≥7 mm患者69例(AHD正常组),AHD<7 mm患者56例(AHD减小组)。比较2组患者术前和术后1年疼痛视觉模拟评分(vsual analogue score,VAS)、Constant-Murley评分、美国加州大学洛杉矶分校肩关节评分(University of California at Los Angeles Shoulder Scores,UCLA)、美国肩肘外科医师学会评分(American Shoulder and Elbow Surgeons,ASES)和肩关节活动度,并进行统计学分析。术后1年根据肩关节MRI影像学Sugaya分型标准评估肩袖愈合情况,比较2组术后肩袖再撕裂发生率。结果2组患者的AHD值比较差异有统计学意义(P<0.05);其他一般资料比较,差异均无统计学意义(均P>0.05)。术后1年时,2组患者的肩关节活动度较术前均有明显改善,差异有统计学意义(P<0.05)。AHD正常组的肩关节活动度(前屈、外展、体侧外旋)优于AHD减小组(均P<0.05)。术后1年,2组的VAS、Constant-Murley、UCLA、ASES评分较术前均有明显改善,差异有统计学意义(均P<0.05)。AHD正常组的VAS、Constant-Murley、UCLA、ASES评分均优于AHD减小组(均P<0.05)。术后1年时复查MRI,AHD正常组再撕裂率为13.0%(9/69),AHD减小组再撕裂率为30.4%(17/56),差异有统计学意义(P=0.018)。结论对于大型和巨大肩袖撕裂患者,AHD正常者比AHD减小者肩袖修复术后疼痛缓解更明显,肩关节功能更好,肩袖再撕裂发生率更低。AHD可以作为大型和巨大肩袖撕裂修复术后临床疗效的一个预测指标。展开更多
目的:对比半月板成形术与修补缝合术治疗膝关节半月板损伤的效果。方法:回顾性选取2020年5月至2022年5月在本院行关节镜手术的62例膝关节半月板损伤患者,根据其手术方案分为成形术组(n=32,关节镜半月板成形术)和修补缝合术组(n=30,关节...目的:对比半月板成形术与修补缝合术治疗膝关节半月板损伤的效果。方法:回顾性选取2020年5月至2022年5月在本院行关节镜手术的62例膝关节半月板损伤患者,根据其手术方案分为成形术组(n=32,关节镜半月板成形术)和修补缝合术组(n=30,关节镜半月板修补缝合术)。收集两组患者临床资料,观察两组临床疗效。对比两组患者围术期相关指标(手术时间、术中出血量、住院时间),采用膝关节疼痛指数(Visual Analogue Scale,VAS)、Lysholm膝关节评分、美国膝关节协会评分(Knee society score,KSS)及关节活动度(Range of motion,ROM)等评价手术前、术后3 m和6 m的膝关节功能及恢复情况。结果:两组患者临床总有效率比较无差异(93.75%vs 90.00%,P>0.05);修补缝合术组的手术时间长于成形组(P<0.05);两组患者术中出血量及住院时间比较均无差异(P>0.05)。与术前比较,术后两组VAS评分均有下降(P均<0.05),且两组比较无差异(P>0.05)。与术前比较,术后两组患者的Lysholm膝关节评分、KSS及ROM均有明显增高趋势(P均<0.05),且成形术组上述指标均高于修补缝合术组(P<0.05)。结论:关节镜下半月板成形术和半月板缝合修补术治疗膝关节半月板损伤的临床疗效相当;应用成形术术后膝关节功能恢复可能更优。展开更多
Objective: The purpose of this study was to evaluate the clinical results of arthroscopic rotator cuff repair with a tape-attached anchor: The HEALICOILRG with ULTRATAPE. We hypothesised that performing arthroscopic r...Objective: The purpose of this study was to evaluate the clinical results of arthroscopic rotator cuff repair with a tape-attached anchor: The HEALICOILRG with ULTRATAPE. We hypothesised that performing arthroscopic rotator cuff repair with tape-attached anchors would result in better clinical outcomes and reduce the retear rate compared with conventional suture anchors. Methods: We included 83 patients treated by arthroscopic rotator cuff repair with a minimum 1-year follow-up. We divided them into two groups: Use of the HEALICOILRG with ULTRATAPE (group T: 41 shoulders;mean patient age, 64.3 years) and use of the conventional suture anchor (group S: 42 shoulders;mean patient age, 68.9 years). We compared the University of California Los Angeles scores, Japanese Orthopaedic Association scores, range of motion, and retear rate between the two groups. The Student t test and chi-square test were used in statistical analyses. Results: At the 1-year postoperative follow-up, both groups showed improvement in the average University of California Los Angeles score, Japanese Orthopaedic Association score, and range of motion, although no significant difference was found in the retear rate between the two groups. Conclusions: Results of arthroscopic rotator cuff repair with the HEALICOILRG with ULTRATAPE were generally good. However, our results could not demonstrate efficacy of the HEALICOILRG with ULTRATAPE. Further detailed studies are needed to determine its treatment result.展开更多
目的:探究关节镜下双滑轮和双排缝线桥联合技术治疗肩袖损伤(rotator cuff tears,RCT)的效果及对肩关节功能恢复的影响。方法:回顾性分析2018年7月至2022年6月于我院接受传统缝线桥技术治疗的52例RCT患者临床资料,纳入对照组,回顾性分...目的:探究关节镜下双滑轮和双排缝线桥联合技术治疗肩袖损伤(rotator cuff tears,RCT)的效果及对肩关节功能恢复的影响。方法:回顾性分析2018年7月至2022年6月于我院接受传统缝线桥技术治疗的52例RCT患者临床资料,纳入对照组,回顾性分析同期于我院接受关节镜下双滑轮结合双排缝线桥技术治疗的53例RCT患者临床资料,纳入观察组。比较两组患者手术指标,随访6个月后,比较两组患者治疗效果[愈合率、再撕裂率、视觉模拟评分(visual Analogue Scale,VAS)],术前和术后6个月关节活动度(前屈上举、体侧外旋、体侧内旋)、肩关节功能[美国肩肘外科协会评分(american Shoulder and Elbow Surgeons,ASES)、Constant-Murley评分(constant-Murley Score,CMS)、加州大学洛杉矶分校评分(university of California at Los Angeles,UCLA)],统计术后并发症发生情况。结果:两组患者手术时间、手术出血量、住院时间及疼痛缓解时间均差异无统计学意义(P均>0.05);术后6个月,两组患者VAS评分较术前降低,观察组低于对照组(P<0.05);前屈上举、体侧外旋、体侧内旋度数、ASES评分、UCLA评分及CMS评分均较术前升高,观察组高于对照组(P均<0.05)。结论:关节镜下双滑轮结合双排缝线桥技术在RCT治疗中效果显著,可加强RCT患者关节灵活度,有利于RCT患者肩关节功能恢复。展开更多
文摘BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,which may increase the risk of morbidity.In response to these concerns,arthroscopic techniques have been evolving.The aim of this study was to introduce a modified arthroscopic tech-nique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series.AIM To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL.METHODS We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL.This case series included 18 patients who underwent the procedure between January 2021 and December 2022.The patients were assessed for range of motion(ROM),Lysholm score and International knee documentation committee(IKDC)score.Postoperative complications were also recorded.RESULTS The patients were followed for a mean of 13.83±2.33 months.All patients showed radiographic union.At the final follow-up,all patients had full ROM and a negative posterior drawer test.The mean Lysholm score significantly improved from 45.28±8.92 preoperatively to 91.83±4.18 at the final follow-up(P<0.001),and the mean IKDC score improved from 41.98±6.06 preoperatively to 90.89±5.32 at the final follow-up(P<0.001).CONCLUSION The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL,with excellent fracture healing and functional recovery.
文摘背景:治疗后交叉韧带胫骨附着点撕脱骨折的最佳手术技术仍值得商榷。随着关节镜手术的应用与成熟,它在后交叉韧带胫骨附着点撕脱骨折的诊疗中有很大前景。目的:综述关节镜技术在后交叉韧带胫骨附着点撕脱骨折治疗中的应用与进展,包括不同关节镜治疗方法、手术入路、胫骨隧道设计、缝合材料选择以及内固定植入物选择等。方法:通过计算机对中国知网、PubMed、Web of Science及ScienceDirect等数据库中的相关文献进行检索,检索时间为2003年1月至2023年11月,中文检索词为“后交叉韧带,后十字韧带,撕脱骨折,关节镜”;英文检索词为“posterior cruciate ligament,avulsion,fracture,tibia,arthroscopic,operation,fixation,treatment”。共纳入97篇文献进行综述。结果与结论:关节镜技术提供了一种可靠的治疗方式来治疗后交叉韧带胫骨附着点撕脱骨折。根据入路、缝合材料类型以及用于缝合的入路和胫骨隧道数量等不同,关节镜技术可以分为关节镜下缝线固定结合自体移植物增强重建、关节镜下多交叉带缝合桥固定、关节镜下高强度缝线固定以及关节镜下直接前后缝合悬吊固定等几类。在各种研究中,常用的临床结果评估指标包括关节活动度、Lysholm评分、国际膝关节文献委员会评分及KT-2000关节测量仪差等,研究显示关节镜手术后末次随访时上述指标检测结果较术前显著改善,影像学随访结果显示关节镜手术都取得了令人满意的结果。在随访过程中,接受关节镜技术治疗后的各类交叉韧带胫骨附着点撕脱骨折患者都未出现严重并发症,例如创伤性关节炎、神经血管损伤、围手术期伤口感染、血栓形成以及骨折不愈合等。
文摘目的探讨关节镜下治疗不同肩肱距离(acromiohumeral distance,AHD)的大型和巨大肩袖撕裂的临床疗效。方法回顾性分析2018年1月至2022年6月于徐州医科大学附属医院骨科接受关节镜治疗的125例大型和巨大肩袖撕裂患者的临床资料。根据AHD不同分为2组,AHD≥7 mm患者69例(AHD正常组),AHD<7 mm患者56例(AHD减小组)。比较2组患者术前和术后1年疼痛视觉模拟评分(vsual analogue score,VAS)、Constant-Murley评分、美国加州大学洛杉矶分校肩关节评分(University of California at Los Angeles Shoulder Scores,UCLA)、美国肩肘外科医师学会评分(American Shoulder and Elbow Surgeons,ASES)和肩关节活动度,并进行统计学分析。术后1年根据肩关节MRI影像学Sugaya分型标准评估肩袖愈合情况,比较2组术后肩袖再撕裂发生率。结果2组患者的AHD值比较差异有统计学意义(P<0.05);其他一般资料比较,差异均无统计学意义(均P>0.05)。术后1年时,2组患者的肩关节活动度较术前均有明显改善,差异有统计学意义(P<0.05)。AHD正常组的肩关节活动度(前屈、外展、体侧外旋)优于AHD减小组(均P<0.05)。术后1年,2组的VAS、Constant-Murley、UCLA、ASES评分较术前均有明显改善,差异有统计学意义(均P<0.05)。AHD正常组的VAS、Constant-Murley、UCLA、ASES评分均优于AHD减小组(均P<0.05)。术后1年时复查MRI,AHD正常组再撕裂率为13.0%(9/69),AHD减小组再撕裂率为30.4%(17/56),差异有统计学意义(P=0.018)。结论对于大型和巨大肩袖撕裂患者,AHD正常者比AHD减小者肩袖修复术后疼痛缓解更明显,肩关节功能更好,肩袖再撕裂发生率更低。AHD可以作为大型和巨大肩袖撕裂修复术后临床疗效的一个预测指标。
文摘目的:对比半月板成形术与修补缝合术治疗膝关节半月板损伤的效果。方法:回顾性选取2020年5月至2022年5月在本院行关节镜手术的62例膝关节半月板损伤患者,根据其手术方案分为成形术组(n=32,关节镜半月板成形术)和修补缝合术组(n=30,关节镜半月板修补缝合术)。收集两组患者临床资料,观察两组临床疗效。对比两组患者围术期相关指标(手术时间、术中出血量、住院时间),采用膝关节疼痛指数(Visual Analogue Scale,VAS)、Lysholm膝关节评分、美国膝关节协会评分(Knee society score,KSS)及关节活动度(Range of motion,ROM)等评价手术前、术后3 m和6 m的膝关节功能及恢复情况。结果:两组患者临床总有效率比较无差异(93.75%vs 90.00%,P>0.05);修补缝合术组的手术时间长于成形组(P<0.05);两组患者术中出血量及住院时间比较均无差异(P>0.05)。与术前比较,术后两组VAS评分均有下降(P均<0.05),且两组比较无差异(P>0.05)。与术前比较,术后两组患者的Lysholm膝关节评分、KSS及ROM均有明显增高趋势(P均<0.05),且成形术组上述指标均高于修补缝合术组(P<0.05)。结论:关节镜下半月板成形术和半月板缝合修补术治疗膝关节半月板损伤的临床疗效相当;应用成形术术后膝关节功能恢复可能更优。
文摘Objective: The purpose of this study was to evaluate the clinical results of arthroscopic rotator cuff repair with a tape-attached anchor: The HEALICOILRG with ULTRATAPE. We hypothesised that performing arthroscopic rotator cuff repair with tape-attached anchors would result in better clinical outcomes and reduce the retear rate compared with conventional suture anchors. Methods: We included 83 patients treated by arthroscopic rotator cuff repair with a minimum 1-year follow-up. We divided them into two groups: Use of the HEALICOILRG with ULTRATAPE (group T: 41 shoulders;mean patient age, 64.3 years) and use of the conventional suture anchor (group S: 42 shoulders;mean patient age, 68.9 years). We compared the University of California Los Angeles scores, Japanese Orthopaedic Association scores, range of motion, and retear rate between the two groups. The Student t test and chi-square test were used in statistical analyses. Results: At the 1-year postoperative follow-up, both groups showed improvement in the average University of California Los Angeles score, Japanese Orthopaedic Association score, and range of motion, although no significant difference was found in the retear rate between the two groups. Conclusions: Results of arthroscopic rotator cuff repair with the HEALICOILRG with ULTRATAPE were generally good. However, our results could not demonstrate efficacy of the HEALICOILRG with ULTRATAPE. Further detailed studies are needed to determine its treatment result.
文摘目的:探究关节镜下双滑轮和双排缝线桥联合技术治疗肩袖损伤(rotator cuff tears,RCT)的效果及对肩关节功能恢复的影响。方法:回顾性分析2018年7月至2022年6月于我院接受传统缝线桥技术治疗的52例RCT患者临床资料,纳入对照组,回顾性分析同期于我院接受关节镜下双滑轮结合双排缝线桥技术治疗的53例RCT患者临床资料,纳入观察组。比较两组患者手术指标,随访6个月后,比较两组患者治疗效果[愈合率、再撕裂率、视觉模拟评分(visual Analogue Scale,VAS)],术前和术后6个月关节活动度(前屈上举、体侧外旋、体侧内旋)、肩关节功能[美国肩肘外科协会评分(american Shoulder and Elbow Surgeons,ASES)、Constant-Murley评分(constant-Murley Score,CMS)、加州大学洛杉矶分校评分(university of California at Los Angeles,UCLA)],统计术后并发症发生情况。结果:两组患者手术时间、手术出血量、住院时间及疼痛缓解时间均差异无统计学意义(P均>0.05);术后6个月,两组患者VAS评分较术前降低,观察组低于对照组(P<0.05);前屈上举、体侧外旋、体侧内旋度数、ASES评分、UCLA评分及CMS评分均较术前升高,观察组高于对照组(P均<0.05)。结论:关节镜下双滑轮结合双排缝线桥技术在RCT治疗中效果显著,可加强RCT患者关节灵活度,有利于RCT患者肩关节功能恢复。
