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Title:Primerjava rezultatov rekonstrukcije sprednje križne vezi s presadkom iz kit mišic fleksorjev in presadkom iz dela kite pogačice
Authors:ID Sajovic, Matjaž (Author)
ID Komadina, Radko (Mentor) More about this mentor... New window
Files:.pdf DR_Sajovic_Matjaz_2013.pdf (13,10 MB)
MD5: F1351DD6D7F874F55676DB9CA4E98550
PID: 20.500.12556/dkum/14cf1525-b341-4325-98fa-e37a0f2bb465
 
Language:Slovenian
Work type:Dissertation
Organization:MF - Faculty of Medicine
Abstract:Izhodišča. Izbira ustreznega presadka v primarni rekonstrukciji sprednje križne vezi (SKV) je s stališča kasnejše stabilnosti in funkcionalnosti kolena še vedno nedorečena. Za ugotovitev morebitnih razlik med obema presadkoma so potrebne dolgoročne, prospektivne, randomizirane študije. Pričujoča študija prikazuje, da obstajajo pet let po operaciji med obema presadkoma statistično pomembne razlike v razvoju degenerativnih sprememb kolenskega sklepa. Metode. Bolnike, ki so bili zaradi pretrgane sprednje križne vezi operirani med junijem 1999 in marcem 2000, smo naključno razdelili v dve skupini. V prvi skupini z 32 bolniki sta bili kot presadek uporabljeni kiti mišic semitendinosus in gracilis (skupina STG), v drugi skupini s prav tako 32 bolniki pa presadek iz dela kite pogačice (skupina PK). Bolniki iz obeh skupin so bili operirani v izmenjujočem vrstnem redu, vse posege je opravil isti kirurg. Rezultati. Za popolno klinično in rentgensko obdelavo je bilo pet let po operaciji iz skupine STG na voljo 28 bolnikov, iz skupine PK pa 26 bolnikov. Po ocenitvenem sistemu Lysholm, kliničnem testiranju, testiranju z artrometrom KT-2000, pojavu sprednje kolenske bolečine, testu poskoka z eno nogo, izokinetičnem testiranju in IKDC rezultatih, med obema opazovanima skupinama nismo našli statistično signifikantnih razlik. 23 bolnikov (82%) iz skupine STG in 23 bolnikov (88%) iz skupine PT se je vrnilo na prejšnjo stopnjo športne aktivnosti. Do ponovne pretrganine sprednje križne vezi je prišlo pri dveh bolnikih iz skupine STG (7%) in pri dveh bolnikih iz skupine PT (8%). Rentgenski znaki degenerativnih sprememb kolenskega sklepa so bili v skupini PT prisotni pri 50% (13/26) bolnikov, v skupini STG pa pri 17% (5/28) bolnikov (P = 0,012). Zaključki. Tako presadek iz kit mišic fleksorjev, kot tudi presadek iz dela kite pogačice omogočata v petletnem opazovalnem obdobju dobre subjektivne rezultate in objektivno stabilnost kolena. Statistično pomembnih razlik med presadkoma v tem pogledu nismo ugotovili. Rentgenski znaki začetnih degenerativnih sprememb so bili v času petih let po operaciji pogostejši pri bolnikih s presadkom iz dela kite pogačice.
Keywords:rekonstrukcija sprednje križne vezi, kite mišic semitendinozus in gracilis, patelarna kita, kanulirani interferenčni vijaki (KIV), osteoartritis, dolgoročna prospektivna randomizirana klinična študija
Place of publishing:Maribor
Year of publishing:2010
PID:20.500.12556/DKUM-39653 New window
COBISS.SI-ID:251277056 New window
NUK URN:URN:SI:UM:DK:0E49GRH7
Publication date in DKUM:18.02.2013
Views:3476
Downloads:376
Metadata:XML DC-XML DC-RDF
Categories:MF
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Secondary language

Language:English
Title:Results comparison of the semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction
Abstract:Background: There are still controversies about graft selection for primary anterior cruciate ligament (ACL) reconstruction. Prospective, randomized, long-term studies are needed to determine the differences between the graft materials. Five years after anterior cruciate ligament reconstruction, there is a difference between hamstring and patellar tendon grafts in development of degenerative knee joint disease. Methods: From June 1999 to March 2000, 64 patients were included in this prospective study. A single surgeon performed primary arthroscopically assisted ACL reconstruction in an alternating sequence. In 32 patients anterior cruciate ligament reconstruction was performed with hamstring tendon autograft (STG group) while in the other 32 patients anterior cruciate ligament reconstruction was performed with patellar tendon autograft (PT group). Results: At the minimum of 5-year follow-up, no statistically significant differences were seen with respect to the Lysholm score, clinical and KT-2000 arthrometer laxity testing, anterior knee pain, single-legged hop test, isokinetic testing or IKDC classification results. 23 patients (82%) in the STG group and 23 patients (88%) in the PT group returned to their preinjury activity level. Graft rupture occurred in two patients from the hamstring tendon group (7%) and in two patients from the patellar tendon group (8%). The grade B abnormal radiographic findings were seen in 50% (13/26) of patients in the PT group and in 17% (5/28) of patients in the STG group (P = .012). Conclusions: Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at five years. No significant differences in the rate of graft failure were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at five years after surgery.
Keywords:anterior cruciate ligament reconstruction, hamstrig tendons, semitendinousus and gracili tendon, patellar tendon, cannulated interference screws (CIS), osteoarthritis, long-term clinical study


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