膝关节镜下保留与未保留残端单束重建治疗前交叉韧带损伤的临床对比

Clinical comparison of the treatment of anterior cruciate ligament injury between with and without preservation stump single bundle reconstruction under arthroscopy

目的:对比膝关节镜下保留与未保留残端单束重建治疗前交叉韧带(ACL)的临床疗效。方法:选择行关节镜下ACL重建的病人30例,随机分为2组,其中采用保留残端单束重建ACL的病人15例(保留组),未保留残端单束重建ACL的病人15例(未保留组)。对比2组术前和术后6个月的Lysholm评分、主观膝部评估表(IKDC)评分和Tegner评分,以及术后膝关节活动度和稳定性,同时比较2组术后6个月的本体感觉指标。结果:2组病人术前的Lysholm评分、IKDC评分和Tegner评分差异均无统计学意义(P>0.05),而保留组术后6个月的Lysholm评分、IKDC评分和Tegner评分均明显高于未保留组(P<0.05)。2组术前和术后6个月的KT-1000侧-侧差值和ROM角度差异均无统计学意义(P>0.05),术后6个月保留组其被动角度再生试验角度和被动活动察觉阈值均低于未保留组(P<0.01)。结论:保留残端单束重建ACL能更好地促进膝关节术后功能和本体感觉的恢复,其临床效果优于未保留残端的ACL重建。

Objective:To compare the clinical efficacy of the treatment of anterior cruciate ligament(ACL)injury between with and without preservation stump single bundle reconstruction under arthroscopy.Methods:A total of 30 patients treated with ACL reconstruction under arthroscopy were randomly divided into the preservation group and unpreservation group(15 cases in each group).The preservation group and unpreservation group were treated with and without ACL reconstruction,respectively.The Lysholm score,IKDC score and Tegner score in two groups between before operation and after 6 months of surgery,and postoperative knee joint mobility and stability between two groups were compared.The propensity indicators after 6 months of operation between two groups were compared.Results:There was no statistical significance in the preoperative Lysholm score,IKDC score and Tegner score between two groups(P>0.05),and the Lysholm score,IKDC score and Tegner score in preservation group after 6 months of operation were significantly higher than those in unpreservation group(P<0.05).There was no statistical significant difference in the side-to-side difference value of KT-1000 and ROM angle in two groups between before operation and after 6 months of operation(P>0.05).The passive angle regeneration test angle and passive activity detection threshold in preservation group after 6 months of operation were lower than those in unpreservation group(P<0.01).Conclusions:The preservation stump single bundle reconstruction of ACL can better promote the recovery of postoperative knee function and proprioception,and the clinical effect of which is better than that of unpreservation stump single bundle reconstruction.