影响前交叉韧带重建术后临床结果的因素分析

Factor analysis of affecting clinical outcome of anterior cruciate ligament reconstruction surgery

目的 探讨影响前交叉韧带重建术临床结果及术后膝关节运动功能保留的因素。方法 回顾性分析2008年1月—2009年12月前交叉韧带单束重建术治疗并获得随访的47例患者,男性32例,女性15例。随访时间24～37个月,平均25.5个月。术后根据IKDC评分将患者分为最佳标准组（n=38例）和未达最佳标准组（n=9例）。并通过对2组的影像学差异进行比较,分析各项影像学数据与术后膝关节功能的相关性。结果 2组患者除移植物股骨止点在正位片的位置无统计学差异,移植物股骨止点在侧位片的位置和股骨隧道在冠状面与矢状面角度比较,差异均有统计学意义。结论 股骨端定位和隧道角度密切影响前交叉韧带重建术后临床结果,故对于前交叉韧带断裂的患者应尽量选择解剖点和更倾斜的骨隧道。

Objective To investigate the factors affecting the clinical outcome of anterior cruciate ligament（ ACL） reconstruction surgery and restoration of motor function of the knee joints. Methods From January 2008 to December 2009,47 patients（ 32 male and 15 female,from 19 to 51 years old with an average of 35. 3 years old） underwent single-bundle anterior cruciate ligament reconstruction and were followed up. According to International Knee Documentation Committee（ IKDC） score,the patients were divided into best standard group（ 38 cases,IKDC score more than 90） and not up to standard group（ 9 cases,IKDC score less than 90）. The imaging data and their relationship to postoperative knee joint function were analyzed and compared between the two groups. Results The difference in the femoral insertion site of graft on anteroposterior film was not significant. The difference in the femoral insertion site of graft on lateral film and femoral tunnel on coronal and sagittal plane were significant. Conclusion There are closely relation between the tunnel angle,attachment of graft and the function of knee. The anterior medial approach with large anatomic femoral tunnel angle should be selected in anterior cruciate ligament reconstruction for the patients with rupture of anterior cruciate ligament.