结合骨折和前十字带重建,改善膝关节功能和稳定性:系统性审查
Thomas E Moran1, Elizabeth K Driskill1, Adam J Tagliero1
1University of Virginia Health System, Department of Orthopaedic Surgery, USA.
概括
结合骨折和前十字带重建 (ACL-R) 有效地减少过度的后斜率 (PTS) 并改善膝盖功能. 这种手术方法在ACL-R手术中显示出更好的结果,特别是在修复病例中.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 生物力学 生物力学
背景情况:
- 过度的后阴斜率 (PTS) 是前十字带重建 (ACL-R) 失败的危险因素.
- 修订ACL-R后的临床结果往往不理想,突出显示了需要改进的外科手术策略的需要.
- 骨折的目的是纠正过度的PTS,可能改善ACL-R的生物力学环境.
研究的目的:
- 系统地审查关于结合骨折与ACL-R的临床和放射性结果的文献.
- 评估这种综合方法在过度PTS的情况下管理ACL缺陷的有效性.
主要方法:
- 使用PubMed,Cochrane图书馆和OVID Medline数据库 (1990年至今) 进行了系统的文献审查.
- 包括的研究重点是用初级或修订ACL-R进行的骨折的结局.
- 提取的数据包括人口统计,手术技术,放射学结果,患者报告的结果和并发症 (证据水平:4).
主要成果:
- 分析了包括133个膝盖在内的6项研究,平均随访时间为3.39年.
- 综合手术显示PTS显著下降,从15.2°降至7.1°.
- 患者报告的结果显著改善,国际膝关节文档委员会,Lysholm和Tegner得分显著增加. 反复发生的ACL移植缺陷很低 (2.25%).
结论:
- 结合ACL-R与小腿骨折骨折的结合似乎有效地减少了过度的PTS.
- 这种手术策略可能会改善膝盖功能和稳定性,为管理过度PTS的ACL缺陷提供一个可行的选择.
- 需要进一步研究以更高水平的证据来巩固这些发现.
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