前交叉韧带重建术后膝关节本体感觉恢复进程的中期研究

The Mid-term Research of the Recover Processes of the Knee Proprioception after the Reconstruction Operation of the Anterior Cruciate Ligament

目的：分析评价利用自体腱行前交叉韧带术后，患者膝关节本体感觉恢复的自然进程。方法：选取我科2009年8月至2010年2月期间收治的确诊为前交叉韧带断裂，并且在关节镜下利用自体半腱肌和股薄肌肌腱重建前交叉韧带的患者42例作为研究对象，采用膝关节被动位置重现分别在术后6月、术后12月、术后24月对所有患者膝关节本体感觉恢复情况进行评价。结果：所有病例均完成随访，无失访。结果提示，在术后6月、术后12月随访中，患者患侧膝关节与健侧膝关节位置重现偏差、患者患侧膝关节与健康者关节位置重现偏差，差异均有显著性意义（P〈0．05）；而健侧膝关节与健康者关节位置重现偏差差异无显著性意义（P〉0．05）。而在术后24月随访中，患者患侧膝关节与健侧膝关节位置重现偏差、患者患侧膝关节与健康者关节位置重现偏差及其健侧膝关节与健康者关节位置重现偏差，差异均无显著性意义（P〉0．05）。结论：利用自体腱行前交叉韧带术后，患者膝关节本体感觉的恢复，在术后12月尚未完全恢复，术后24月则与健侧及健康人无明显差异。

Objective： To analyse and evaluate the natural processes of the knee-joint proprio- ception regeneration of the patients with the treatment of the Anterior Cruciate Ligament（ACL） sur- gery by the means of the autogenous tendon. Methods.. 42 patients with the ACL rupture and recon- structed ACL in using Semitendinosus muscle and gracilis tendon under the arthroscopy in our divi- sion from August 2009 to February 2010 were selected as the research subjects. They all were adopt- ed the reproduction of passive position of the knee-joint to evaluate on the knee-joint propriocep- tion regeneration of all the patients respectively at the sixth postoperative month, the twelfth postop- erative month, the twenty-fourth postoperative month. Results： All cases had been follow-up with- out defaulting. The results suggested that the difference of the deviation of position recurrence be- tween patients＇ diseased side knee and healthy side knee, and the deviation of position recurrence between patients＇ diseased side knee and healthy subjects＇ knee was significant in the follow up of 6 months and 10months after operation（P〈0.05）, and the difference of the deviation of healthy side knee and healthy subjects＇ knee was on significant（P〉0.05）. In the follow up of 24 months after op- eration, the difference of the deviation of position recurrence between patients＇ diseased side knee and healthy side knee, the deviation of position recurrence between patients＇ diseased side knee and healthy subjects＇ knee as well as the healthy side knee and healthy subjects＇ knee was on significant （P〉0.05）. Conclusion： After the reconstruction operation of the ACL by using the self-tendon, the natural processes of the knee proprioception regeneration of the patients had not been fully restored in 12months after operation, but they are no obvious difference with the healthy side knee and healthy subjects＇ knee in 24months after operation.