关节镜下解剖与传统单束重建前交叉韧带疗效比较

Comparative study of efficacy of arthroscopic anatomic and traditional single-bundle ACL reconstructions

目的比较解剖与传统单束重建前交叉韧带的疗效。方法回顾性分析2008年7月~2012年9月沧州市中心医院就诊的44例前交叉韧带重建患者的临床资料,根据治疗方法分为传统组(22例,采用传统单束重建前交叉韧带)和解剖组(22例,采用解剖单束重建前交叉韧带)。采用主观功能指标(IKDC、Lysholm评分)和客观稳定性指标(Lachman、轴移试验及KT-1000)比较两组膝关节术后疗效。结果两组患者术后IKDC、Lysholm评分与术前相比明显提高(P<0.01),但两组间比较,差异无统计学意义(P>0.05)。两组患者术后Lachman试验和KT-1000较术前明显改善(P<0.01),两组间比较,差异无统计学意义(P>0.05),但轴移试验术后解剖组优于传统组(P<0.05)。结论解剖单束和传统单束重建ACL均能较好地恢复膝关节前向稳定性,但是解剖单束重建在恢复膝关节旋转稳定性方面明显优于传统单束重建。

Objective To compare the curative effects of arthroscopic anatomic and traditional single-bundle ACL re- constructions. Methods From July 2008 to September 2012, in Cangzhou Central Hospital, the clinical data of 44 pa- tients underwent single-bundle ACL reconstructions were retrospective analyzed, and they were divided into two groups according to the treatment method, anatomy group （with arthroscopic anatomic, single-bundle ACL reconstructions, 22 cases） and tradition group （with traditional single-bundle ACL reconstructions, 22 cases）. The subjective indexes （IKDC and Lysholm score scale） and objective indexes （Lachman test, pivot shift test and KT-1000） were adopted to assess the function and stability of knee joint. Results IKDC, Lysholm scores of two groups after operation improved than before operation （P 〈 0.01）, but there were no significant differences between groups （P 〉 0.05）. Lachman test, KT-1000 of two groups after operation improved than before operation （P 〈 0.01）, there were no significant differences between groups （P 〉 0.05）, but Pivot shift test showed that anatomy group was obviously better than tradition group （P 〈 0.05）. Conclusion Both arthroscopic anatomic and traditional single-bundle ACL reconstructions can restore frontward stabil- ity of knee well, but arthroscopic anatomic single-bundle reconstruction is better than the traditional single-bundle re- construction in knee rotational stability.