Operative management of acute PCL injuries with associated pathology: long-term results.
Operative management of acute PCL injuries with associated pathology: long-term results.
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DOI：
10.3928/0147-7447-19910601-10
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发表时间：
1991-06
期刊：
影响因子：
1.1
通讯作者：
G. Barrett;F. Savoie
中科院分区：
文献类型：
--
作者：
G. Barrett;F. Savoie
回顾了18例后交叉韧带损伤的患者及其相关病理学。所有患者均进行了复查，平均随访时间为5.4年（范围：3.5至7.5年）。用多根2号不可吸收缝线将6根后交叉韧带修复至股骨，并在每个残端用缝线修复了1根“拖把端”中间物质撕裂。用半腱肌腱修复并加固了7处中间物质撕裂，而用半腱肌腱和Dacron支架（Meidon）修复并加固了另外4处中间物质撕裂。一个内侧半月板被修复，一个被部分切除，一个外侧半月板撕裂被部分切除。两个膝关节将前交叉韧带修复到胫骨，两个膝关节单独保留（间质性撕裂），五个膝关节切除关节外髂胫束肌腱固定术。随访时，关节测量仪读数（斯特赖克）与临床检查结果相关性良好。4个使用Dacron支架的膝关节在90度时的差异为0 - 1 mm，而失效大于5 - 6 mm。其中6个在单独修复组，2个在半腱肌增强修复组。8个膝关节（44.5%）的影像学改变主要发生在内侧间室。使用Hughston的周长来评估结果，客观的55.5%被评为良好，27.8%被评为一般，16.7%被评为差或失败。使用Clancy标准，22.2%为优，22.2%为良，44.5%为一般，11.1%为失败。（250字处删节）
Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology were reviewed. All were re-examined with an average follow up of 5.4 years (range: 3.5 to 7.5). Six posterior cruciate ligaments were repaired to the femur with multiple #2 nonabsorbable suture, and one "mop end" mid-substance tear was repaired with sutures in each stump. Seven mid-substance tears were repaired and augmented with the semitendinosus tendon, while four additional mid-substance tears were repaired and augmented with the semitendinosus tendon and a Dacron stent (Meadox). One medial meniscus was repaired and one was partially excised, and one lateral meniscus tear was partially excised. The anterior cruciate ligament was repaired to the tibia in two knees, left alone (interstitial tear) in two, and excised with extraarticular iliotibial band tenodesis augmentation in five. At follow up, arthrometer readings (Stryker) correlated well with clinical examination. The four knees with Dacron stent had a 0 to 1 mm difference at 90 degrees, while the failures had greater than 5 to 6 mm. Six of these were in the repair alone group and two were in the repair with semitendinosus augmentation group. Eight knees (44.5%) had radiographic changes primarily in the medial compartment. Using Hughston's perimeters to evaluate the results, objective 55.5% were rated good, 27.8% were rated fair, and 16.7% were rated poor or failures. Using Clancy's criteria, 22.2% were excellent, 22.2% were good, 44.5% were fair, and 11.1% were rated failures.(ABSTRACT TRUNCATED AT 250 WORDS)