半腱肌腱移植重建.ppt

Semitendinosus Tendon Graft Versus a Modified Weaver-Dunn Procedure for Acromioclavicular Joint Reconstruction in Chronic Cases A Prospective Comparative Study 半腱肌肌腱移植与改良Weaver-Dunn 手术重建慢性肩锁关节损伤 一项前瞻性对照研究 Mark Tauber, MD*?, Katharina Gordon, MD?, Heiko Koller, MD?, Michael Fox, MD? and Herbert Resch, MD? ?Department of Traumatology and Sports Injuries, University Hospital of Salzburg, Salzburg, Austria, and the ?Royal National Orthopaedic Hospital, Stanmore, United Kingdom Am J Sports Med January 2009 vol. 37 no. 1 181-190 Biomechanical studies comparing various surgical techniques for acromioclavicular joint reconstruction have reported that semitendinosus tendon graft for coracoclavicular ligament reconstruction provides a substantial improvement in initial stability and a load-to-failure equivalent to the intact coracoclavicular ligaments. Although it represents a biomechanical improvement compared with coracoacromial ligament transfer, there is still a lack of prospective comparative studies confirming the clinical relevance of these biomechanical findings. Background 肩锁关节重建外科技术的生物力学研究表明，半腱肌肌腱移植重建喙锁韧带提供了一个可靠的初步稳定性，抗疲劳载荷与完整喙锁韧带相当。虽然在生物力学上优于喙肩韧带转移，但临床是还缺乏前瞻性对照研究来证实生物力学结果。 背景 Semitendinosus tendon graft for coracoclavicular ligament reconstruction is associated with superior clinical results compared with a modified Weaver-Dunn procedure in chronic complete acromioclavicular joint dislocation. Hypothesis 对于慢性肩锁关节完全脱位，半腱肌肌腱移植重建喙锁韧带在临床上优于Weaver – Dunn术。 假设 Cohort study; Level of evidence, 2. 队列性研究，证据等级，2级 Study Design Twenty-four patients (mean age, 42 years) with painful, chronic Rockwood type III through V acromioclavicular joint dislocations were subjected to surgical reconstruction. In 12 patients, a modified Weaver-Dunn procedure was performed; in the other 12 patients, autogenous semitendinosus tendon graft was used. Clinical evaluation was performed using the American Shoulder and Elbow Surgeons shoulder score and the Constant score after a me