后交叉韧带损伤早期与延期治疗关节内并发症分析及临床疗效评价

Comparisons of Complications and Prognosis in Posterior Cruciate Ligament Ruptured Patients Who Received Early and Delayed Surgical Interventions

目的:对比分析单纯后交叉韧带损伤的患者早期治疗(≤6周)和延期治疗(>6周)关节内并发症发生情况及术后疗效。方法:回顾性分析我科自2010年2月至2017年6月收治单纯后交叉韧带损伤行关节镜手术治疗的患者共121例,依据患者受伤至手术间隔时间对患者进行分组,间隔时间6周及6周以内的患者为早期组(60例患者),间隔时间超过6周的患者为延期组(61例患者)。分别记录年龄、性别、侧别、受伤原因、时间间隔、随访时间,疼痛VAS评分、膝关节功能Lysholm评分及IKDC评分。对比两组患者术中所见并发症分布情况,并对两组患者术后膝关节疼痛及功能情况进行随访和评价。结果:两组患者术后的VAS评分、膝关节Lysholm评分及IKDC评分较术前均有明显改善,但早期组患者的术后VAS评分更低,Lysholm评分及IKDC评分更高,两组患者之间术后评分比较存在统计学差异(P<0.05)。延期组患者关节内软骨损伤明显高于早期组(P<0.05)。两组患者半月板损伤及髁间窝狭窄发生率无明显差异(P>0.05)。结论:PCL损伤常合并关节内软骨损伤,随着时间推移关节内各个间室软骨损伤均明显增加。PCL损伤应尽早行手术治疗,恢复膝关节的稳定性,以减少关节内软骨损伤,最大程度恢复膝关节的功能。

Objective To compare and analyze the complications and prognosis of posterior cruciate ligament(PCL)ruptured patients with early(≤6 weeks)and delayed(>6 weeks)surgical interventions.Methods A total of 121 patients treated with arthroscopic surgery for isolated posterior cruciate ligament injury in our department between February 2010 and June 2017 were retrospectively analyzed and classified into two groups according to the operation timing.Among them,60 patients undergoing surgical interventions within 6 weeks of their injury were selected into the early group,while 61 receiving reconstruction 6 weeks later after the injury were chosen into the delayed group.The age,gender,affected side,cause of injury,time interval between injury and operation,follow-up time,visual analogue score(VAS),Lysholm score and the International Knee Documentation Committee knee evaluation form(IKDC)score were recorded for both groups.The distribution of intraoperative complications was compared between the two groups,and the VAS score and knee functional score of the two groups were followed up and evaluated.Results Compared with the preoperative knee function,both groups showed significant improvement in the average VAS score,Lysholm score and IKDC score after the operation.However,the early group had significantly lower postoperative VAS score and higher Lysholm score and IDDC score(P<0.05).The intra-articular cartilage injury in the delayed group was significantly higher than that in the early group(P<0.05).However,there was no significant difference in the incidence of meniscus injury and intercondylar fossa stenosis between the two groups(P>0.05).Conclusion PCL injuries are often associated with intra-articular cartilage injuries,and with the passage of time,intra-articular interentricular cartilage injuries increase significantly.PCL injury should be treated with surgery as soon as possible to restore the stability of the knee joint,which can reduce intra-articular cartilage injury and restore the function of the knee joint to the greatest extent.