内侧髌股韧带的2种解剖重建技术的比较:一项前瞻性随机研究

Comparison of 2 different techniques for anatomic reconstruction of the medial patellofemoral ligament: A prospective randomized study
作者:Kang, H. , Cao, J., Yu, D., Zheng, Z., Wang, F.
机构: 石家庄市第一医院整形外科
期刊: AM J SPORT MED2013年5月5期41卷

Department of Orthopaedic Surgery, Shijiazhuang No. 1 Hospital, No. 36 Fanxi Road, Shijiazhuang, 050011, Hebei, China

 

Background: The comparative clinical outcome of anatomic reconstruction of the medialpatellofemoral ligament (MPFL) between the Y-graft technique and C-graft technique for chronic patellar instability is unknown. Hypothesis: Anatomic reconstruction of the MPFL with aY-graft technique (a Y-shaped graft: femoral fixation first with separate tensioning of the 2bundles) would yield better clinical results than a C-graft procedure (a C-shaped graft: patellar fixation first with simultaneous tensioning of both bundles) for chronic patellar instability. StudyDesign: Randomized controlled trial; Level of evidence, 2. Methods: Ninety patients with symptomatic chronic patellar dislocations or instability were randomly divided into 2 groups to undergo double-bundle MPFL reconstruction either with the Y-graft technique or C-grafttechnique. Follow-ups were performed at 3, 6, 12, and 24 months postoperatively. The patellar stability was evaluated with the apprehension test at follow-up. The patellofemoral morphological characteristics were evaluated on axial computed tomography (CT) scans at 30° of knee flexion, and knee function was evaluated using the Lysholm and Kujala scores preoperatively and at 24 months postoperatively. Results: Forty patients in the Y-graft group and 42 patients in the C-graft group were followed for 24 months. No recurrent dislocation or subluxation was reported in either group. On CT scans, congruence angle, patellar tilt angle, lateral patellar angle, and lateral displacement were restored to the normal range. The mean postoperative Lysholm scores for the Y-graft group and C-graft group were 92.3 ± 3.9 and 88.4 ± 6.8, respectively (P = .001). The mean postoperative Kujala scores were 95.9 ± 4.7 and 91.3 ± 9.7 for the Y-graft group and C-graft group, respectively (P = .001), with a good or excellent rate of 97.5% in the Y-graft group compared with 83.3% in the C-graft group (P = .031). Conclusion: With no patellar redislocations reported, the Y-graft technique for the double-bundle anatomic MPFL reconstruction achieved statistically better knee function than the C-graft procedure at a minimum 2-year follow-up. However, the increase was less than the minimal clinically important difference, and further research is required to demonstrate its meaningful clinical improvement.

 

 

通讯作者:Kang, H.; Department of Orthopaedic Surgery, Shijiazhuang No. 1 Hospital, No. 36 Fanxi Road, Shijiazhuang, 050011, Hebei, China; email:doctorkanghj@yeah.net
学科代码:整形外科学   关键词:Anatomic reconstruction; Media
来源: Scopus
Scopus介绍:Scopus 于2004年11月正式推出,是目前全球规模最大的文摘和引文数据库。Scopus涵盖了由5000多家出版商出版发行的科技、医学和社会科学方面的18,000多种期刊,其中同行评审期刊16,500多种。相对于其他单一的文摘索引数据库而言,Scopus的内容更加全面,学科更加广泛,特别是在获取欧洲及亚太地区的文献方面,用户可检索出更多的文献数量。通过Scopus,用户可以检索到1823年以来的近4000万条摘要和题录信息,以及1996年以来所引用的参考文献。数据每日更新。 马上访问Scopus网站http://www.scopus.com/
顶一下(0
您可能感兴趣的文章
    发表评论网友评论(0)
      发表评论
      登录后方可发表评论,点击此处登录