良性多发关节松弛症对前交叉韧带损伤及预后的影响

Effect of benign hypermobility of joints on injury and outcome of anterior cruciate ligament

目的探讨前交叉韧带(anterior cruciate ligament,ACL)损伤和关节松弛之间的相关性。方法对2010年1月-2011年12月于我院骨科就诊的102例ACL损伤患者和154例健康者进行对照研究。关节松弛的诊断依据为Beighton评分。ACL损伤采用关节镜辅助下自体腘绳肌腱重建韧带,于术后12个月采用Lanchman试验和前抽屉试验评估关节稳定性。结果ACL损伤患者关节松弛度Beighton评分≥4分占38.2%(39例);正常对照组Beighton评分≥4分占20.8%(32例),两组间差异有统计学意义(P<0.05)。多发关节松弛患者术后稳定性评价阴性26例,阳性13例;无多发关节松弛患者术后稳定性评价阴性57例,阳性6例,两组间差异有统计学意义(P<0.05)。结论 ACL损伤与多发关节松弛有一定相关性,关节松弛患者预后较差。

Objective To study the correlation between injury of anterior cruciate ligament （ACL） and benign hypermobility of joints. Methods One hundred and two patients with ACL injury admitted to our department from January 2010 to December 2011 and 154 healthy subjects were comparatively studied. Benign hypermobility of joints was diagnosed according to Beighton scale. Twelve months after arthroscopy-assisted ACL reconstruction with hamstring tendon autograft, the joint stability was assessed respectively by Lanchman＇s test and anterior drawer test. Results Beighton scale was no less than 4 in 39 （38.2%） of the 102 patients with ACL injury and in 32 （20.8%） of the 154 healthy subjects （P 〈 0.05）. The joint stability tests with benign hypermobility of joints were negative in 26 patients and positive in 13 patients after operation whereas they were negative in 57 patients and positive in 6 patients without benign hypermobility of joints after operation （P 〈 0.05）. Conclusion ACL injury is correlated with benign hypermobility of joints. The outcome of arthroscopy-assisted ACL reconstruction is poorer in patients with benign hypermobility of joints.