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題名 | Endoscopic Anterior Cruciate Ligament Reconstruction with Autogenous Bone-Patellar Tendon-Bone Graft=完全使用關節鏡以自體中三分之一矉骨韌帶重建膝關節前十字韌帶 |
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作 者 | 吳重達; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 30:3 民86.05-06 |
頁次 | 頁199-205 |
分類號 | 416.61 |
關鍵詞 | 關節鏡; 矉骨韌帶重建; 膝關節前十字韌帶; Anterior cruciate ligament; Endoscopic; Reconstruction; Bone-patellar tendon-bone autograft; |
語文 | 英文(English) |
中文摘要 | 十一例膝關節前十字韌帶斷裂病人,五例為運動傷害,人例為車禍,接 受自體中三分之一檳骨韌帶重建手術。手術方法完全使用關節鏡,移植物以 Kurosaka螺絲釘固定,經骨端加鋼螺絲釘柱與鋼絲加強固定。術後採漸進、保護 性復建。追蹤結果平均LysholmScore為87.2分,KT-ioorMaxminalManual由術前平均 差異5.6降為1.6。Lachmanntest一例為I-A,其餘為正常。Ante,nor Drawertest三例 為I-A.,其餘為正常。Pivot Shift test一例為第一度,其餘為正常。膝關節伸展缺 失五度有一例,另一例為屈曲缺失。十例仍有股四頭肌萎縮。主觀上十位病人滿 意重建手術之結果,一位評為尚可。對於膝關節斬十字韌帶斷裂且出現膝關節不 穩定症狀的病人,自體中三分之一矉骨韌帶移植重建手術可提供滿意的穩定度與 近乎正常之功能。完全使用關節鏡之重建手術要求熟練的關節鏡技術與較長的 Learning Curve。重建手術後積極的復建工作為影響手術結果之重要因素。 |
英文摘要 | The purpose of this paper is to evaluate the surgical results of endoscopicbone-patellar tendon-bone anterior cruciate ligament (ACL) reconstruction. Eleven patients, 4 males and 7 females had surgery between July 1993and April 1995. Their ages ranged from 16-48 years (33.82 ± 10.68). The causesof injury was sport-related in 5 and traffic accident induced in 6 patients.All patients had endoscopic autogenous bone-patellar tendon-bone ACLreconstruction. The results were evaluated with physical examinations,KT-1000 arthrometer and Lysholm scores. The mean follow-up period was26.8±6.7 months (20-33 months). Objective physical examinations done atthe latest follow-up showed 1 patient had a 1-A Lachmann test, 3 patientshad 1-A anterior drawer tests and 1 patient had a grade 1 pivot-shift test.Subjectively all patients rated the results as satisfactory, except the 1patient with the grade 1 pivot-shift test, the result considered merelyacceptable. Pre-operative KT-1000 maximum manual difference was 5.60±1.47 mm., which reduced to 1.60± 0.65 mm at the latest follow-up. The preoperative Lysholm score was 30.82 ± 19.28 which improved to 87.19 ± 9.38at the latest follow-up. There was 1 patient who had an extension lag of 5degrees and another had a flexion deficit (0-110 degrees). Ten patientsstill had quadriceps atrophy, 2.0 ± 0.94 cm, at the latest follow-up. Thoughthe number of cases was limited and the follow-up period was relativelyshort, the results were both satisfactory and encouraging. |
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