前交叉韧带部分断裂后加强性单束重建术与保守治疗的疗效比较

A comparison of clinical outcome of augmentation reconstruction technique and conservative treatment for partial anterior cruciate ligament tears

目的:研究前交叉韧带(ACL)部分断裂后加强性单束重建手术与保守治疗的疗效差异,以指导临床治疗。方法:回顾性收集48名ACL部分断裂患者,根据治疗方法分成保守治疗组(21例)与加强性单束重建术组(27例)两组,所有患者随访两年,评价指标包括IKDC评分、Lysholm评分、Tegner评分、膝关节活动度(ROM)和kneelax关节动度测量仪测量结果。结果:保守治疗组两年随访结束时膝关节功能评分显著高于受伤时(P<0.05),kneelax测量结果与受伤时差异无统计学意义(P>0.05);加强性单束重建术组膝关节功能评分及kneelax测量结果术后较术前显著提高(P<0.05),随访两年结束时kneelax测量结果显著高于保守治疗组(P<0.05),而膝关节功能评分结果及ROM较保守治疗组差异无统计学意义(P>0.05)。结论:ACL部分断裂后采用加强性单束重建手术治疗比保守治疗更有利于患膝稳定性的恢复。

Objective： To compare the outcomes between augmentation reconstruction technique and conservative treatment for partial anterior cruciate ligament（ ACL） tears. Methods： Forty-eight patients with partial ACL tears were divided into conservative treatment group（ n = 21） and augmentation reconstruction group（ n = 27） with a minimum follow- up of 2 years. Clinical outcomes were evaluated just after the injury and at the latest follow-up with several parameters,including the International Knee Documentation Committee（ IKDC） score,Lysholm knee score,Tegner activity rating,range of motion（ ROM） and the kneelax arthrometer. Results： In the conservative treatment group,the functional outcomes were improved significantly at 2-year follow-up（ P〈0. 05）,and no difference was found in the knee laxity outcomes（ P〉0. 05）. In the augmentation reconstruction group,the functional and the knee laxity outcomes were improved significantly between the pre-operative and post-operative assessment（ P〈0. 05）. Meanwhile,the knee stability was significantly improved in the augmentation reconstruction group compared with that in the conservative treatment group at 2-year follow-up（ P〈0. 05）,and in terms of functional and ROM outcomes there were no statistically differences between the two groups（ P〉0. 05）. Conclusion：Our study indicates that augmentation reconstruction technique is more beneficial to the knee stability than conservative treatment for the partial ACL tears.