关节镜下分期治疗渔民膝关节多发韧带损伤

Staged surgery for multiple knee ligament injuries in fishermen with arthroscopy

目的观察关节镜下分期治疗渔民膝关节多发韧带损伤的临床疗效。方法 15例膝关节多发韧带损伤的渔民患者一期修复外侧副韧带、内侧副韧带和半月板,术后1周开始功能锻炼;待患者屈膝超过110°和伸膝无障碍,二期关节镜下重建前交叉韧带和后交叉韧带。术后1年评估膝关节功能恢复情况。结果 15例患者均获随访,时间14～34个月,平均21个月。1例屈膝受限25°,3例屈膝受限10°～15°,无伸膝受限;内外翻应力试验均阴性,2例Lachman试验（＋）,1例后抽屉试验（＋＋）,3例后抽屉试验（＋）。Lysholm膝关节功能评分术前（42.6±8.2）分,术后1年（86.9±5.6）分（P〈0.05）。结论关节镜下分期治疗是治疗渔民膝关节多发韧带损伤的一种有效的方法。

【Objective】To observe the treatment outcome of staged surgery with arthroscopy for the fishermen with multiple knee ligament injuries.【Methods】Fifteen fishermen with multiple knee ligament injuries whose lateral collateral ligament, medial collateral ligament and meniscus were repaired in stage 1 started functional exercise one week after surgery. In stage 2, arthroscopic reconstructive procedures for the injured cruciate ligaments were performed after a minimum 110° flexion and full extension were regained. The total knee function was evaluated with Lysholm scale one year after surgery.【Results】All cases were followed up for an average of 21 months（range, 14 to 34 months）. One year postoperative knee extension, the valgus stress testing and the varus stress testing restored to normal in all cases; 25° flexion limitation was found in 1 case; 10° to 15° flexion limitation was found in 3 cases.Two cases were found with Lachman test（＋）; 1 case was found with the posterior drawer test（＋＋）, and 3 cases（＋）.The Lysholm knee score were（42.6±8.2） before operation and（86.9±5.6） one year after operation. There was significant difference between preoperative and postoperative scores（P 〈0.05）.【Conclusion】It is an effective method in treatment of multiple knee ligament injuries in the fishermen by staged management with arthroscopy.