在青少年前十字关节重建后的关节纤维化与四肢肌与骨块自移植后的关节纤维化
Dallyn Udall1, Remy Zimmerman2, Halle Walls2,3
1Riverside University Health System, Moreno Valley, California, USA.
Orthopaedic journal of sports medicine
|September 11, 2025
概括
儿童前十字带重建 (ACLR) 使用四头肌与骨块 (QTB) 显示3个月的关节纤维化率很高. 然而,在麻醉下进行操纵的需要与其他移植类型相似.
科学领域:
- 整形外科手术 整形外科手术
- 儿科运动医学 儿科运动医学
- 生物医学工程 生物医学工程
背景情况:
- 带有骨块 (QTB) 的四肌自体移植越来越多地用于儿科患者的前十字带重建 (ACLR).
- 虽然患者报告的结果在2年后是有利的,但对该人群中QTB移植的关节纤维化发病率的研究是有限的.
- 儿科ACLR后关节纤维化病的一般发病率在所有移植类型中从2%到10%不等.
研究的目的:
- 用 QTB 来确定ACLR 治疗的儿科患者的关节纤维化发病率.
- 为了将这些发现与关于全软组织四头骨自移植的现有文献进行比较.
主要方法:
- 80名儿科患者 (≤17岁) 的回顾性审查,他们在2019年至2023年期间接受了QTB的初级ACLR.
- 收集的数据包括人口统计,保险类型,以及手术前,手术期间和手术后的记录.
- 术后3个月评估了关节纤维化,通过特定的曲和延伸缺陷来定义.
主要成果:
- 术后3个月发生的关节纤维化发生在27.5% (22/80) 的患者中.
- 平均随访时间为13.3个月,8.8% (7/80) 需要在麻醉下进行操纵 (MUA).
- 减少了手术前曲,减少了6周的术后曲,并与此同时进行了中侧阴茎修复,这些都是关节纤维化症的显著预测因素.
结论:
- 患有QTB的儿科ACLR的3个月关节纤维化率高于以前报告的其他移植类型.
- 尽管最初的发病率较高,但MUA的发病率与其他移植相比较.
- 术前和术后早期的膝盖曲和中间阴茎修复状态是预测关节纤维化症的关键指标.
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