关节镜术诊断和治疗军事训练前交叉韧带不完全损伤

Diagnosis and treatment of acute incomplete anterior cruciate ligament injury of knee joint in military training by arthroscopy

目的探讨军事训练导致急性膝关节前交叉韧带(ACL)不完全损伤患者的关节镜术诊断意义和治疗方法。方法2003年3月～2006年8月收治军事训练导致的急性膝关节ACL不完全损伤患者30例,所有患者均早期行关节镜检查确诊,其中关节镜下射频皱缩术后保守治疗5例,I期行加强手术13例,Ⅰ期行重建手术12例,术后对所有病例观察随访,记录临床检查结果和Lysholm评分。结果术后随访8～16个月,平均12个月,膝关节主观和客观稳定性均明显改善,Lysholm评分从术前(40±5)分提高到术后(92±6)分(P<0.01)。结论军事训练急性膝关节ACL不完全损伤患者早期应首选关节镜检查,以明确诊断,确定损伤程度。选择合理的治疗方法,Ⅰ期镜下修复或重建对早期恢复膝关节稳定有重要的临床意义。

[ Objective ] To explore diagnostic effect and treatment method of arthroscopy for acute incomplete anterior crueiate ligament （ACL） injury of knee joint in military training. [Methods ] Totally 30 patients with acute incomplete ACL injury of knee joint in military training were admitted to our department and diagnosed early by arthroscopy from March 2003 to August 2006. Of all, 5 cases were treated conservatively after radiofrequency shrinkage under arthroscope, 13 cases managed with ACL augment operation and 12 cases with ACL reconstruction at one stage. All the patients were followed up after operation. The clinical examination and Lysholm scores were recorded. [Results] The follow-up time was 8-16 months, averaged 12 months. The subjective and objective stabil- ities of knee joint improved significantly. Lysholm scores raised from （40±5） preoperatively to （92±6） points postoper- atively （P 〈0.01）. [ Conclusion ] Arthroscopy should be the early choice for acute incomplete ACL injury of knee joint in military training to ensure diagnosis and evaluate injury. Appropriate treatment, and early repair or reconstruction of the damaged ACL by arthroseopy are of clinical importance for early recovery of knee stabilization.