前十字韧带重建术前后TT-TG的变化及临床意义

Change of TT-TG and its clinical significance after anterior cruciate ligament reconstruction

目的探讨前交叉韧带损伤患者韧带重建术前术后TT-TG值差异变化及临床意义。方法回顾我院2015年12月∽2016年6月前十字韧带损伤并行韧带重建术的45例患者的术前术后及健侧膝关节TT-TG值,运用SPSS17.0软件进行统计学分析,比较其变化规律。结果健侧膝关节TT-TG值(13.55±1.74)与文献参考值(13.6±8.8)比较,差异无统计学意义(P>0.05)。术前TT-TG值(8.90±1.17)较文献参考值(13.6±8.8)变小,差异有统计学意义(P<0.05),术前TT-TG值由(8.90±1.17)改变至术后(13.99±1.95),TT-TG值变大,差异有统计学意义(P<0.05),术后TT-TG值(13.99±1.95)与文献参考值(13.6±8.8)比较,差异无统计学意义(P>0.05)。结论前交叉韧带损伤的患者在韧带损伤后,胫骨相对于股骨发生了内旋,致TT-TG值变小,韧带重建术后,患膝胫骨内旋畸形被纠正,TT-TG值恢复至正常。通过TT-TG值术前术后测量的对比可间接评价前十字韧带损伤患者膝关节胫骨内旋畸形的程度及韧带重建术后纠正胫骨内旋畸形的效果。

Objective To discuss TT-TG differences and its clinical significance after anterior cruciate ligament reconstruction in patients with ligament damage. Methods Patients who were given anterior cruciate ligament reconstruction therapy from December 2015 to June 2016 were reviewed and their TT-TG values at contralateral knees before operation and after operation were examined. Data were analyzed using the SPSS17.0 statistical software. Results TT-TG values at contralateral knees were 13.55 ＋ 1.74, and there was no statistically significant difference compared with values in literature（13.6 ＋ 8.8）（P〉0.05）. Preoperative TT-TG values were 8.90± 1.17 which were smaller than the values in literature（13.6 ＋ 8.8）, and their difference was statistically significant（P〈0.05）. But preoperative TT- TG values changed to 13.99 ±1.95 after operation, and the difference between preoperative values and postoperation value was statistically significant（P〈0.05）. Furthermore, postoperative TT-TG values was 13.99 ＋ 1.95, which was no statistically significantly different compared with values in literature（13.6 ＋ 8.8）（P〉0.05）. Conclusion Patients with anterior cruciate ligament injury have internal rotation of tibia relative to the femur that means TT-TG have been smaller than before. The knee tibial internal rotation deformity was corrected and TT-TG was back to normal after ligament reconstruction surgery. Comparing TT-TG values before operation and after operation can indirectly evaluate the degree of tibial rotation deformity in patients who have anterior cruciate ligament injury and correct the tibial internal rotation deformity.