关节镜下一期修复膝关节多韧带损伤临床研究

Clinical Outcome of One-stage Arthroscopic Reconstruction of Multi-ligament Injury of Knee

目的：探讨关节镜下一期修复膝关节多韧带损伤的可行性及临床疗效。方法：2007年2月至2012年8月收治膝关节多韧带损伤患者52例，男30例。女22例。平均年龄36．4岁；其中ACL及MCL损伤14例，ACL及LCL损伤8例，PCL及MCL损伤3例，PCL及LCL损伤2例，ACL及PCL损伤8例，ACL、PCL及MCL损伤15例，ACL、PCL及LCL损伤2例，所有患者均于关节镜下行一期修复。术后采用Lysholm功能评分、IKDC评分及主动关节活动度评估患膝功能。结果：所有患者均得到随访。平均随访24．8个月（6～48个月）。入院时IKDC评分均为显著异常（D级），术后末次随访时IKDC评分：正常（A级）32例（62％），接近正常（B级）14例（27％），异常（C级）6例（11％）。末次随访时．Lysholm膝关节功能评分由术前36．7±5．7（0～70）分提高至86．5±11．2（49-100）分；主动关节活动度由术前73．2°±15．1°（15°-125°）提高至120．1°±7．30（90°～1350）；与术前比较，差异均有统计学意义（P〈0．05）。结论：关节镜下一期重建ACL、PCL及修复MCL、LCL，是治疗膝关节多韧带损伤的安全、有效方法。

Objective In this study, we attempt to explore the feasibility and clinical outcome of one- stage arthroscopic reconstruction of knee multi-ligament injury. Methods From February 2007 to August 2012,52 patients with knee ligament injury, including 30 males and 22 females,averagely aged 36.4 years,were treated in our department. Among the patients,there were 14 cases of combined ACL and MCL injury, 8 of combined ACL and LCL injury, 3 of combined PCL and MCL injury,2 of combined PCL and LCL injury,8 of combined ACL and PCL injury, 15 of combined ACL,PCL and MCL injury, and 2 of combined ACL, PCL and LCL injury. All injured knee of the patients were repaired by one- stage arthroscopy. The function of knees after surgery was evaluated according to the Lysholm function score,IKDC score and active range of motion. Results All patients were followed up averagely 24.8 months （6-48 months）. IKDC score of patients was significantly abnormal （grade D）at the admission, however,the follow up after surgery showed that there were 32 cases of grade A （62%）, 14 of grade B （27%） ,and 6 of grade C（11%）;the Lysholm knee function score increased from 36.7±5.7（0-70）to 86.5° 11.2（49±100） （P 〈 0.05）,and active range of motion increased from 73.2°±15.1°（15°-125°）to 120.1±7.3° （90°-135°） （P 〈 0.05）. Conclusion Arthroscopic reconstruction of multiple ligament injury of knee is asafe and effective method.