Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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A Comparison of Outcomes after Acute and Chronic Anterior Cruciate Ligament Reconstruction

급성 및 만성 전방십자인대 재건술의 결과 비교

  • Lee, Ju-Hong (Department of Orthopedic Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Bae, Hyun-Kyung (Department of Orthopedic Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Kim, Ki-Bum (Department of Orthopedic Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Hwang, Byung-Yun (Department of Orthopedic Surgery, Saint Carollo Hospital) ;
  • Lim, Young-Jin (Department of Orthopedic Surgery, Saint Carollo Hospital) ;
  • Song, Ji-Hun (Department of Orthopedic Surgery, Saint Carollo Hospital) ;
  • Jung, Myung-Guk (Department of Orthopedic Surgery, Saint Carollo Hospital)
  • 이주홍 (전북대학교 의학전문대학원 정형외과학교실, 임상의학연구소) ;
  • 배현경 (전북대학교 의학전문대학원 정형외과학교실, 임상의학연구소) ;
  • 김기범 (전북대학교 의학전문대학원 정형외과학교실, 임상의학연구소) ;
  • 황병연 (성가롤로병원 정형외과) ;
  • 임영진 (성가롤로병원 정형외과) ;
  • 송지훈 (성가롤로병원 정형외과) ;
  • 정명국 (성가롤로병원 정형외과)
  • Received : 2009.07.22
  • Accepted : 2010.03.29
  • Published : 2010.08.30
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Abstract

Purpose: To compare the clinical outcomes of a reconstruction with an autogenous hamstring tendon for an acute and chronic anterior cruciate ligament (ACL) injury. Materials and Methods: We reviewed 71 patients who had undergone an ACL reconstruction with an autogenous hamstring tendon from December 2003 to June 2006. The patients were divided into two groups, reconstruction for an acute injury with 34 knees and reconstruction for a chronic injury with 37 knees. The clinical results were evaluated using the Lysholm score, International Knee Documentation Committee (IKDC) score, Lachman test, Pivot shift test, KT-1000 arthrometer, and a Cybex isokinetic test for the strength of the knee flexor and extensor. The presence of associated intra-articular lesions was also investigated. Results: There were no significant differences between the two groups in terms of the stability evaluated by the Lachman test, pivot shift test and KT-1000 arthrometer at the final follow-up (p=0.732, 0.479, 0.078). However, the acute group scored significantly higher with respect to the clinical outcome measured by the Lysholm scores and IKDC rating system at the final follow-up (P=0.042, 0.012). There was a significantly higher incidence of associated intra-articular lesions in the chronic group than those in the acute group (P=0.003). Conclusion: A reconstruction for acute ACL injuries showed more satisfactory clinical results and less associated intra-articular lesions than a reconstruction for chronic ACL injuries.

목적: 급성 및 만성 전방십자인대 손상에 따른 인대 재건술 후 임상적 결과를 비교하였다. 대상 및 방법: 2003년 12월부터 2006년 6월까지 자가 슬괵건을 이용한 전방십자인대 재건술 후 최소 2년 이상 추시 관찰이 가능했던 71예 중 34예의 급성 손상 재건군과 37예의 만성 손상 재건군을 대상으로 하였다. 임상적 결과는 Lysholm 점수, IKDC 점수, Lachman 검사, Pivot shift 검사, KT-1000 관절계 검사, Cybex 등속성 운동검사를 이용하여 평가하였고, 각 군에 존재하는 관절 내 동반손상을 조사하였다. 결과: 최종 추시에서 Lachman 검사, Pivot shift 검사, KT-1000 관절계 검사에 따른 슬관절 안정성은 두 군 간 통계학적 유의성은 없었으나(p=0.732, 0.479, 0.078), Lysholm 점수, IKDC 점수로 평가한 임상적 결과는 급성손상 재건군에서 통계학적으로 유의하게 높았다(p=0.042, 0.012). Cybex 등속성 운동 검사 결과는 두 군 간 유의한 차이를 보이지 않았지만(p=0.619, 0.717, 0.536, 0.119). 관절 내 동반 손상은 급성 손상 재건군에 비해 만성 손상 재건군에서 유의하게 많았다(p=0.003). 결론: 급성 전방십자인대 손상의 재건술은 만성 손상 재건술에 비해 슬관절 안정성에는 차이가 없었지만 보다 나은 임상적 결과 및 적은 빈도의 관절내 동반손상을 보였다.

Keywords

References

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