반건양건 단일 4가닥을 이용한 전방십자인대 재건술의 중기 추시 결과

• Published in: The journal of the Korean Orthopaedic Association Vol. 50; no. 5; pp. 387 - 393
• Main Authors: 박호원(Ho-Won Park), 김희준(Hee-June Kim), 경희수(Hee-Soo Kyung), 한정원(Jung-Won Han)
• Format: Journal Article
• Language: Korean
• Published: 대한정형외과학회 01.10.2015
• Subjects: 정형외과학; anterior cruciate ligament reconstruction; 전방십자인대 재건술; semitendinosus tendon; 반건양건
• ISSN: 1226-2102; 2005-8918

목적: 반건양건 단일 4가닥을 이용하여 단일 다발 전방십자인대 재건술을 시행한 후 중기 추시 결과를 조사했다. 대상 및 방법: 2006년 6월부터 2009년 6월 사이 경북대학교병원에서 반건양건 단일 4가닥을 이용한 단일 다발 전방십자인대 재건술을 시행받은 81명 84예에 대해 분석하였다. 평균 나이 28.8세, 수상 후 수술까지의 기간은 평균 9개월, 평균 추시 기간은 72개월이었다. 임상적 평가로 Lachman 검사, pivot-shift 검사, KT-2000 관절계 검사, Lysholm 점수, Tegner 활동점수, International Knee Documentation Committee (IKDC) 주관적 점수, 수상 전 운동 상태로의 복귀를 조사하였고, 방사선 검사로 관절 간격 협소 등을 관찰하였다. 결과: 전체 예에서 관절 운동범위는 정상으로 회복됐고, Lachman 검사 양성 4예, pivot-shift 검사 양성 3예, Lysholm 점수 92.2점, Tegner 활동점수 6점, IKDC 주관적 점수 86.5점, KT-2000 관절계 계측상 건측과 2.3 mm 차이, 수상 전 활동으로 복귀가 80.2%였다. 방사선적 관절간격의 변화는 수술 전, 후 의미 있는 차이는 없었다. 결론: 반건양건 단일 4가닥을 이용한 단일 다발 전방십자인대 재건술 후 중기 추시 결과 관절의 안정성이 유지되며 임상적으로 만족할 만한 결과를 얻었다. Purpose: The purpose of this study was to evaluate the mid-term results after anterior cruciate ligament (ACL) reconstruction using a single four-strand semitendinosus tendon. Materials and Methods: We evaluated 81 patients (84 cases) who had undergone ACL reconstruction using an autologous single four-strand semitendinosus tendon. The patients consisted of 77 men and 4 women with a mean age of 28.8 years (15-59 years) years. Most injuries were sports related, and the largest number of cases occurred during a soccer game (38 cases). Combined injuries were meniscus injuries in 43 cases, cartilage injuries in 6 cases and medial collateral ligament injuries in 8 cases. Femoral fixation device was PINN-ACL CrossPin in 44 cases and extracortical suspension device in 40 cases. Suture tie around a screw post and an additional bioabsorbable screw were used for tibial fixation. The mean time from injury to surgery was 9±16 months (7 days-10 years) and the mean follow-up period was 72.0±8.3 months (53-95 months). Clinical evaluation was performed using Lachman test, pivot-shift test, KT-2000 arthrometer, Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score and return to pre-injury sports activity. Radiologic evaluation was performed using plain radiographs to evaluate joint space narrowing. Results: All patients showed normal range of motion at the final follow-up. The Lachman test was positive in 4 cases, and pivot-shift test was positive in 3 cases. Lysholm score improved from 76.7 to 92.2, Tegner activity score improved from 5.1 to 6, IKDC score improved from 72.0 to 86.5, and mean anterior translation by KT-2000 improved from 7.4 mm to 2.3 mm, and 80.2% of patients returned to pre-injury sports activity. No significant differences in joint space narrowing were observed in plain radiographs. Conclusion: In this study, good results were obtained after ACL reconstructions using the autologous four-strand single semitendinosus tendon with maintaining the joint stability at mid-term follow-up. KCI Citation Count: 0