前交叉韧带重建术后膝关节位置觉和运动觉的早期观察研究

A preliminary study in proprioception and kinesthetic sense of knee joint after anterior cruciate ligament reconstruction

目的观察关节镜下自体腘绳肌腱单双束重建前交叉韧带患者术后早期膝关节位置觉和运动觉的恢复情况,并比较有无差异。方法50例单侧前交叉韧带损伤后重建患者非随机分为两组,单束重建组26例,双束重建组24例,移植物均为自体腘绳肌腱;正常对照组12例。术后对患者进行KT2000关节测量,膝关节被动位置重现和运动感知阈值测量,同时对其IKDC2000膝关节主观功能评分和Lysholm膝关节评分进行观察;对照组进行双侧膝关节被动位置重现和运动感知阈值测量。结果比较两组病例术后膝关节的前向稳定性和功能评分以及位置觉和运动觉结果,差异均无统计学意义(P>0.05);两病例组与正常对照组相比较,位置觉和运动觉结果差异均有统计学意义(P<0.05)。结论前交叉韧带重建术后早期患者膝关节的位置觉和运动觉并未恢复到正常水平;前交叉韧带单束重建术和双束重建术患者术后早期膝关节位置觉和运动觉恢复水平并无差异。

Objective To compare the postoperative recovery of prorioception and kinesthestic sense of knee joint between single-bundle and double-bundle anterior cruciate ligament（ACL） reconstruction. Methods Fifty patients with unilateral ACL reconstruction were unrandomly divided into two groups. Twenty-six patients were reconstructed by hamstring tendon autografls with single-bundle technique, and the other 24 patients with double-bundle technique. As control 12 normal individuals were included. Each patient underwent KT2000 measurement and the detection of knee joint position and motion sense postoperatively. They also filled the IKDC subjective knee evaluation form and Lysholm scale at the same time. The normal controls were measured position and motion sense of bilateral knee joints. Results There were no significant differences of anterior stability, subjective evaluation, position and motion sense of knee joint between single-bundle double-bundle group （P〉0.05）. But, there were significant differences of knee joint position and motion sense between patient groups and normal controls（P〈0.05）. Conclusion The restoration of knee joint position and motion sense has not been to a normal level in the preoperative stage. There are no differences of the postoperative restoration of knee joint position and motion sense between the groups of single-bundle and double-bundle reconstruction technique.