Primary Anterior Cruciate Ligament Reconstruction by Dacron Prosthesis Augmented with Iliotibial Band or Fascia Lata: A 14-year Subjective Outcome Study

以自體組織加強後之達克隆人工韌帶進行前十字韌帶重建手術：十四無長期的主觀研究結果報告

許弘昌(Horng-Chaung Hsu) ； 黃鐙樂(Teng-Le Huang) ； 吳濬哲(Jiunn-Jer Wu)

《Mid-Taiwan Journal of Medicine》 12卷4期 (2007/10) Pp. 191-197

https://doi.org/10.6558/MTJM.2007.12(4).3

摘要

目的　我們對於以達克隆人工韌帶進行前十字韌帶重建手術進行一個回溯型研究來評估其主觀結果。
方法　針對64位曾經接受達克隆人工前十字韌帶重建手術的病人進行研究，平均追蹤10.9年。所有的達克隆人工韌帶都以自體組織包裹，並以「越過頂點」的手術方式重建。追蹤的重點在於主觀的結果評估：包括林氏膝部評估表、鐵格氏活動評估表、以及滿意度的評估。
結果　十二位病人在平均四點五年的時候接受達克隆人工韌帶移除手術。在最後一次的追蹤，我們發現整體的林氏膝部評估爲81.4分，鐵格氏活動評估爲5.3分。有40%的病人是「普通」到「不好」的結果，有高達45%的病人不滿意他們最後的結果。
結論　我們認爲以人工韌帶來進行前十字韌帶重建手術的長期追蹤結果仍不儘滿意。以自體韌帶來進行前十字韌帶重建手術，仍爲目前最可靠的重建方式。

關鍵字

達克隆人工韌帶 ； 前十字韌帶重建

並列摘要

Purpose. A retrospective cohort study was conducted to evaluate the subjective long-term results of Dacron prosthetic ligaments in the management of primary anterior cruciate ligament reconstruction.
Methods. Sixty-four patients who underwent primary anterior cruciate ligament reconstruction with a Dacron prosthesis were followed for a mean of 10.9 years. Ligaments were reconstructed with a Dacron prosthesis augmented with either the iliotibial band or the fascia lata, using a modified Macintosh over-the-top technique. The subjective outcomes were evaluated by the Lysholm knee scoring scale, the Tegner activity scale and patient's satisfaction based on visual analog scale assessment.
Results. Dacron prostheses were removed within a mean interval of 4.5 years in 12 patients (19%). The mean overall Lysholm knee score was 81.4 and the mean Tegner activity rating scale was 5.3. More than 40% of patients had fair to poor outcomes and more than 45% reported being dissatisfied with the prosthesis at the most recent follow-up.
Conclusion. Prosthetic ligaments are still far from being perfect. Reconstruction with autologons graft remains the standard procedure for anterior cruciate ligament reconstruction.

並列關鍵字

anterior cruciate reconstruction ； Dacron prosthetic ligament