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OBJECTIVE@#To observe the curative effect of one-stage reconstruction of anterior cruciate ligament(ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL) in patients with KD-Ⅲ-M knee injury, and to compare the operation time, hospitalization cost and curative effect after arthroscopic reconstruction of PCL with LARS artificial ligament and autogenous hamstring tendon, ACL reconstruction with autogenous hamstring tendon and MCL repair combined with limited incision.@*METHODS@#From March 2016 to January 2019, a total of 36 patients met the criteria of this study. Twenty patients in group A were treated with autogenous hamstring tendon reconstruction of ACL and PCL and repair of MCL, including 17 males and 3 females, with an average age of (34.7±9.2) years old. Sixteen patients in group B with LARS artificial ligament reconstruction of PCL, with an autogenous hamstring tendon reconstruction of PCL and MCL repair as before as group B, including 15 males and 1 female, with an average age of (36.8±8.6) years old. The operation time, hospitalization time and total hospitalization cost were compared between the two groups. The preoperative and postoperative functions of the two groups were evaluated by Hospital for Sepcial Surgery (HSS) score and Lysholm score respectively, and the curative effects were compared within and between groups.@*RESULTS@#All the patients in the two groups were followed up for at least 1 year. There were no complications such as infection and poor wound healing in both groups. There was significant difference in operation time between (120.25±9.55) min in group A and (106.63±8.85) min in group B (@*CONCLUSION@#There was no significant difference in the average hospitalization days between the two groups, but the operation time in group A was longerthan that in group B, and the hospitalization cost in group B was higher than that in group A. There was no difference in HSS score and Lysholm score before and follow-up for a certain period of time after operation.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament Injuries/surgery , Arthroscopy , Hamstring Tendons/surgery , Knee Dislocation , Knee Joint/surgery , Posterior Cruciate Ligament/surgery , Posterior Cruciate Ligament Reconstruction , Treatment OutcomeABSTRACT
Objective@#To observe the difference of the clinical effect of using high-strength woven suture or not in the reconstruction of posterior cruciate ligament (PCL) with single tendon autograft under arthroscope.@*Methods@#The clinical data of 40 patients with posterior cruciate ligament rupture and ligament reconstruction admitted to Shengjing Hospital Affiliated to China Medical University from 2017 to 2018 were analyzed retrospectively.According to whether or not to add Arthrex ar-7200 (Arthrex, Naples, FL, USA) braided suture in the autogenous hamstring graft, the patients were divided into test group (17 cases) and control group (23 cases). The posterior drawer test (PDT) was used as the knee joint stability test to evaluate the knee function, IKDC score, Lysholm score and Tegner score were used as the evaluation criteria.The evaluation results of the knee joint in the experimental group and the control group were compared before and one year after the operation, and the evaluation results of the knee joint in the two groups were compared one year after the operation and one year before the operation@*Results@#Functional aspects of knee joint: The Lysholm score of the experimental group was expressed by median (quartile) 1 year before and after operation.Lysholm scores of the trail group were 64 (40, 81) and 84 (73, 87) preoperative and postoperative, respectively, the control group were 68 (48, 78) and 80 (70, 90) respectively, there was statistically difference before and after surgery (Z value was -2.535 and -3.576, P value was 0.011 and<0.001, respectively). There was no statistically significant difference between groups (all P>0.05). The Tegner score of the experimental group before and 1 year after operation was expressed as the median [quartile], which was 2.0 (1.0, 2.5), 6.0 (5.0, 7.5) respectively, and that of the control group was 2.0 (1.0, 3.0), 6.0 (4.0, 7.0) respectively.There was statistically significant difference between the two groups before and after operation (Z value was -3.397, -4.122, all P<0.001), but there was no statistically significant difference between the two groups (all P>0.05). One year after operation, the IKDC scores of the two groups were significantly improved (Z values were -3.750, -4.234, all P<0.001), but there was no significant difference between the two groups (P>0.05). There was no significant difference between the two groups in the postoperative drawer test (P>0.05); one year after the operation, the stability of the two groups was significantly improved (Z values were -3.674, -4.083, all P<0.01), and the stability of the experimental group was significantly better than that of the control group(Z=0.156, P=0.039).@*Conclusion@#Posterior cruciate ligament reconstruction with autologous hamstring muscle can achieve satisfactory clinical results, and placing high-strength braided sutures in the graft is more conducive to the recovery of knee joint stability.
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Objective To investigate the effect of the use of autologous hamstring tendon plus peroneal longus tendon and the application of LARS artificial ligament reconstruction of posterior cruciate ligament (PCL) knee function and recovery of mechanical stability. Methods Forty-three patients with posterior cruciate ligament rupture were divided into two groups according to the type of graft used during the operation : the LARS artificial ligament group (22 cases) and the autologous hamstring tendon plus peroneal longus tendon group (21 cases). The postoperative follow-up time was at least two years. The knee joint function was evaluated using the knee joint Lysholm score, IKDC score, and Tegner score. The post-drawer test evaluated mechanical stability. Results After 43 cases were followed up completely, the knee joint stability and function indexes of the two groups were significantly improved compared with preoperative ones. The differences were statistically significant (P < 0.05).At the same time, for all postoperative scores, two There was no significant difference between groups (P> 0.05).Conclusion The application of autologous hamstring tendons plus peroneal longus tendon anterior bundle and LARS artificial ligament reconstruction posterior cruciate ligament can achieve satisfactory clinical curative effect.
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Objective Clinically, the anterior cruciate ligament ( ACL) can be reconstructed by either ligament advanced reinforcement system ( LARS) artificial ligament or hamstring tendon autograft ( HTAG) . This study aims to compare the early clinical outcomes of LARS versus HTAG in the treatment of ACL. Methods This study included 38 cases of ACL injury treated in our de-partment from March 2012 to August 2014, 18 by LARS artificial ligament and the other 20 by HTAG. Before and at 18 months after surgery, we evaluated the clinical outcomes of the tow strategies using the Lysholm knee scoring scale and International Knee Documen-tation Committee ( IKDC) scoring systems, and conducted statistical analysis on the follow-up findings. Results Statistically signifi-cant differences were not observed preoperatively between the LARS and HTAG groups either in the Lyshrolm scores (46.78±1.52 vs 46.80 ±1.89, P>0.05) or in the IKDC scores (42.83±1.47 vs 42.20±1.61, P>0.05), nor at 18 months postoperatively in the Lyshrolm scores (93.52±3.19 vs 94.10±1.37, P>0.05) or the IKDC scores (92.11± 1.45 vs 93.15±1.76, P>0.05). However, both the LARS and HTAG groups showed significant differences in the Lyshrolm and IKDC scores at the baseline as compared with those at 18 months after oper-ation ( P<0.05) . Conclusion Both LARS artificial ligament ham-string tendon autograft can achieve good early clinical outcomes in ACL reconstruction.
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PURPOSE: To analyze comparatively the results of arthroscopic ACL reconstructions using autogenous hamstring tendon with (group II) and without (group I) it's tibial detachment. MATERIALS AND METHODS: A retrospective study of 22 patients (group I; 10, group II; 12) treated with arthroscopic reconstruction using autogenous hamstring tendon was performed. The average follow-up period was 18 months. Functional and clinical results were evaluated according to Clancy's criteria and the Lysholm knee scoring scale. Postoperative anterior laxity was measured using a KT-2000 arthrometer. Using the group I technique, an animal study was done to compare the tension strengths of the afferent and efferent limbs of the graft material. RESULTS: The mean Lysholm knee score was 82.5 points in group I and 87.8 points in group II at the last follow up. Anterior laxity was 2.9 mm in group I and 1.9 mm in group II at the last follow up. Functional evaluation using Clancy's criteria, showed that 7 patients (70%) in group I and 11 patients (91.6%) in group II had an excellent or a good result. In the animal study, a difference was found between the tension strengths of the the afferent and efferent limbs. CONCLUSION: The results of ACL reconstruction in group II were better than those of group I, and the group II technique had the advantage of an graft even tension.