全内技术与传统技术重建前交叉韧带的临床疗效对比研究

Clinical outcomes comparison of all inside technique with traditional technique in anterior cruciate ligament reconstruction

背景:全内技术重建前交叉韧带是近年来的新技术之一,最主要特点是只需取一条腘绳肌腱。目的:比较全内技术与传统技术重建前交叉韧带的临床疗效。方法:自2014年1月至2016年10月,对45例膝前交叉韧带重建患者的临床资料进行回顾性分析,其中男32例,女13例,年龄18~33岁,平均(24.2±3.3)岁。采用全内技术重建22例(全内组),传统技术重建23例(传统组)。记录并比较两组手术距受伤时间、手术时长、术后VAS评分、膝关节功能恢复情况。采用国际膝关节文献委员会(IKDC)及Lysholm评分系统对临床疗效进行综合评估。结果:45例患者随访14~18个月,平均(15.4±1.3)个月,两组手术距受伤时间、手术时长、末次随访患膝的IKDC及Lysholm评分均无统计学差异,VAS评分在术后第1天、第3天、第7天、2周及1个月的差异有统计学意义(P<0.05),术后3个月,6个月及1年差异无统计学意义。结论:全内技术重建前交叉韧带疗效与传统方法相当,但术后疼痛较传统方法轻,是一种较为理想的治疗选择。

Background: The "all inside" anterior cruciate ligament(ACL) reconstruction is one of the newest techniques,which is characterized as only one hamstring tendon taken. Objective: To compare the effects of all inside and traditional techniques in anterior cruciate ligament reconstruction. Methods: 45 patients undergoing anterior cruciate ligament reconstruction were retrospectively studied and divided into two groups from January 2014 to October 2016, including 32 males and 13 females,ranging from 18 to 33 years old with an average age of(24.2±3.3) years. 22 patients were treated with all inside technique in anterior cruciate ligament reconstruction(all inside group), 23 patients underwent reconstruction of the anterior cruciate ligament with traditional technique(traditional group). The time from trauma to operation, surgery time, visual analog scale(VAS) pain score, the function of knee joint were recorded and analyzed. The therapeutic effects were evaluated by International Knee Documentation Committee Score and Lysholm score. Results: All patients were followed up for 14 to 18 months,(15.4± 1.3) months in average. There were no significant differences in the time from trauma to operation,surgery time,IKDC scores or Lysholm scores at the final follow up between the two groups. Compared with the traditional group, the VAS pain scores were significantly lower in the all inside group at 1 day, 3 days,7 days, 2 weeks and 1 month postoperatively(P<0.05),but there was no significant difference at 3 months, 6 months and 1 year postoperatively. Conclusions: All inside technique has the similar efficacy with the traditional technique;however, it has lighter pain than the traditional technique, which is a good choice for anterior cruciate ligament reconstruction.