自体腘绳肌腱重建前交叉韧带术后康复的临床研究

Clinical Research between Three Different Rehabilitation Procedures Following ACL Autograft Reconsruction with Hamstring Tendons Severe Emphysema

目的观察比较自体腘绳肌腱重建前交叉韧带(ACL)术后三种不同康复方案的临床效果。方法将单侧自体腘绳肌腱重建膝关节ACL手术的患者45例,随机分为保守康复组(A组),激进康复组(B组)和自制康复组(C组),每组15例。术后3、6、12个月时比较关节活动受限度、大腿周径差值、IKDC评分、三维重建CT检查移植物骨隧道直径。结果三组在关节活动度受限及大腿肌肉萎缩方面:术后3、6、12个月A组明显大于B、C组,有显著性差异(P<0.05);IKDC评分方面:术后3、6、12个月C组优于A、B组,有显著性差异(P<0.05);骨隧道扩大方面:B组明显大于A、C组,有显著性差异(P<0.05)。结论自体腘绳肌腱重建膝关节ACL术后早期康复可以改善膝关节功能,但是并非越激进越好,应以适度康复为原则。

Objective To compare the efffets of the three different rehabilitation procedures following ACL autotograft reconstruction with hamstring tendons. Methods 45 patients were undergone ACL restruetions by using quadrupled semitendinosus and graeilis tendons, and divided into three groups： accelerated reabilitation procedures group （groupA）, aggressive rehabilitation procedures group （groupB）, self-made rehabilitation procedures group （groupC）. The knee range of motion, thigh perimeter, IKDC score and bone tunnel diameter in 3D-CT films were evaluated at three months, six months and 1 year later. Results The knee rang of motion and thigh perimeter of group A was higher than those of group B and group C at 3, 6 and 12 months. IKDC scores of group C were better than that of group A and 13. The bone tunnel widening with group B was larger than that with group A and group C, and the differenees were statistieally signifieant（P〈0. 05）. Conclusion Early rehabilitation is benefit for restoration of knee function after ACL reeonstruetion. Moderate procedure is better than accelerated.