前交叉韧带解剖重建中不同股骨侧固定方式对术后骨道扩大及对膝关节国际膝部文件委员会主观膝部评分的影响

Analysis of the Influence of Different Femoral Lateral Fixation Methods on Postoperative Osseous Expansion and International Knee Documentation Committee Subjective Knee Score during Anterior Cruciate Ligament Anatomical Reconstruction

目的探讨前交叉韧带解剖重建中不同股骨侧固定方式对术后骨道扩大及对膝关节国际膝部文件委员会(IKDC)评分影响.方法选取2018年1月—2019年1月沈阳医学院附属中心医院收治的50例经自体腘绳肌单束解剖重建前交叉韧带患者作为研究对象,随机分为观察组与对照组各25例.观察组给予Rigidfix系统固定,对照组给予Endobutton系统固定,比较两组患者的IKDC评分、Lysholm评分、KT-1000评分及P_(1)、P_(2)、P_(3)、P_(4)骨道直径.结果术前观察组与对照组的IKDC评分、Lysholm评分及KT-1000差异无统计学意义(P>0.05);术后3个月观察组与对照组的IKDC评分、Lysholm评分及KT-1000差异无统计学意义(P>0.05).观察组的P1位置的骨道直径短于对照组,差异有统计学意义(P<0.05);观察组与对照组的P_(2)、P_(3)、P_(4)位置的骨道直径差异无统计学意义(P>0.05).结论Rigidfix系统与Endobutton系统应用于股骨侧固定中均具有较为显著效果,其中前者的骨髓道内口扩张较小,但两种固定方法均不会对膝关节功能造成不利影响,可根据患者具体情况选择合适的固定方法.

Objective To investigate the effect of different femoral fixation methods on postoperative bone enlargement and International Knee Documentation Committee(IKDC)Subjective Knee Score in anatom ical reconstruction of anterior cruciate ligament.Methods A total of 50 patients with anterior cruciate ligam ent reconstruction with autologous hamstring muscles from January 2016 to April 2017 were enrolled.The patients were divided into observation group and control group according to different femoral fixation methods.The observation group was fixed by Rigidfix system,the control group was fixed by Endobutton system,and the IKDC score,Lysholm score,KT-1000 score and P_(1),P_(2),P_(3),P_(4)bone diameter of the two groups were observed and evaluated.Results There was no significant difference in IKDC score,Lysholm score and KT-1000 between the preoperative observation group and the control group(P>0.05).The IKDC score,Lysholm score and KT-1000 of the observation group and the control group were observed 3 months after operation,there was no significant difference(P>0.05).The diameter of the bone at the P,position of the observation group was shorter than that of the control group with statistical significance(P<0.05).There was no difference in the diameter of the bone at the P_(2),P_(3),and P_(4)positions between the observation group and the control group(P>0.05).Conclusion The Rigidfix system and Endobutton system have significant effects in the treatment of femoral lateral fixation.The former has a small intramural expansion of the bone marrow tract,but neither method can adversely affect the knee joint function.The appropriate fixation method can be selected according to the specific situation of patients.