膝关节多韧带损伤一期重建后5年随访

One-stage reconstruction after knee joint multi-ligaments injury during 5-year follow-up

背景:前后交叉韧带损伤合并Ⅲ度内侧副韧带损伤严重影响膝关节的稳定性,重建后短期疗效确切,但中期疗效尚不明确。目的:评估多韧带损伤重建后的中期疗效。方法:选择40例前后交叉韧带损伤合并Ⅲ度内侧副韧带损伤的患者,男30例,女10例,年龄19-48岁,前后交叉韧带损伤于关节镜下行同种异体肌腱重建,内侧副韧带损伤行带线铆钉修补。重建前后行Lachman试验、IKDC分级、Lysholm评分及KT-1000对患者进行主观和客观评分,以评估重建疗效。结果与结论:40例患者均获随访,随访时间60个月。重建后患者膝关节疼痛、肿胀、屈伸活动受限等症状明显改善,Lachman试验、Lysholm膝关节功能评分、IKDC分级评分及KT-1000较重建前明显提高(P<0.05),提示应用同种异体肌腱重建前后交叉韧带、带线铆钉修补内侧副韧带,能有效恢复膝关节的稳定性,短中期疗效确切。

BACKGROUND： Anterior and posterior cruciate ligament injury combined with Ⅲ degree medial collateral ligament injuries has damage to the stability of the knee joint, short-term efficacy has been confirmed, but the medium-term efficacy is not plausible. OBJECTIVE： To assess the medium-term efficacy after multi-ligaments injury reconstruction. METHODS： A total of 40 patients with anterior and posterior cruciate ligament injury combined with Ⅲ degree medial collateral ligament injuries were selected （30 males, 10 females, age from 19-48 years old）. All the patients with anterior and posterior cruciate ligament injury received allogeneic tendon reconstruction under arthroscopy, and the patients with medial collateral ligament injury were repaired with rivet. The Lachman test, IKDC classification, Lysholm scores and KT-1000 value were performed before and after surgery to evaluate the efficacy of reconstruction. RESULTS AND CONCLUSION： A total of 40 cases were followed-up for 60 months. All preoperative symptoms got better apparently, such as the pain of the knee joint, swelling and limitation of range of motion. The Lachman test, IKDC classification, Lysholm scores and KT-1000 value after reconstruction were significantly increased when compared with that prior to surgery （P 0.05）. The results demonstrate that allogeneic tendon reconstruction of anterior and posterior cruciate ligaments and reconstruction of medial collateral ligament with rivet can recovery the stability and knee function, It also has advantages in short-term efficacy and medium-term efficacy.