关节镜下髌韧带和腘绳肌腱重建前交叉韧带的术后康复疗效对比

Rehabilitation Effectiveness after Reconstruction of Anterior Cruciate Ligament under Arthroscopy Using Patellar Ligament and Hamstring Ligament

探讨分别采用自体髌韧带和自体腘绳肌腱作为移植物进行前交叉韧带重建术,术后的康复训练对患者产生的康复疗效的对比。由回顾自2007年6月至2008年10月因前交叉韧带(ACL)断裂行关节镜下韧带重建术的患者20例;移植物分别采用自体髌韧带和自体腘绳肌腱;所有手术均由同一组医生完成。术前和术时检查数据表明两组患者间各项指标无显著性差异,具有可比性。术后这些患者全部在解放军总医院第二附属医院康复科进行康复训练,康复时间均为三个月以上,术后三个月进行康复评定,主要检查关节稳定性、活动度、日常活动和运动能力恢复情况。膝关节功能用Lysholm膝关节评分法评定,术后康复三个月后髌韧带组和腘绳肌腱组Lysholm评分无显著性差异(P>0.05),关节活动度的恢复两组也无明显差异(P>0.05),恢复均良好。但是髌韧带的膝前疼痛比例(60%)比腘绳肌腱的膝前疼痛比例(10%)高。说明关节镜下采用自体髌韧带和自体腘绳肌腱重建前交叉韧带的康复疗效无明显差异,但采用髌韧带重建的术后并发症较多,所以对于两者不同移植物,在康复过程中要有着重点。

To observe the function recovery of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament ,a total of 20 cases ,of which 10 cases were with BTB and 10 with HT were reconstructed under arthroscopy by the same surgeon from June 2006 to October 2007. The two groups were comparable before operation. After operations, all of the 20 cases received rehabilitation training in Rehabilitation Department of Shanghai East Hospital. The duration of rehabilitation is more than 3 months. And the patients were evaluated in terms of the range of motion, stability,the functional status in daily activities in the third month. Function of knee was evaluated by Lysholm,difference of Lysholm score between the BTB group and the HT group was not statistically significant （P 〉 0.05）. The stability of the knee in the two groups were identical （P 〉 0.05）, the effectiveness is all right. But the rate of ache in the front of knee in BTB group（60%） is higher than that in HT group（10%）. It is conclused that rehabilitation effectiveness after reconstruction of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament is no significant differences. But in the BTB group, complications after operation are more than that in the HT group. So some emphases should be have in the process of rehabilitation for different implants.