前交叉韧带残端保留自体腘绳肌腱重建术对膝关节功能、稳定性及本体感觉影响

Effects of autologous hamstring reconstruction with anterior cruciate ligament stump preservation on knee function,stability and proprioception

目的探讨关节镜下前交叉韧带(anterior cruciate ligament,ACL)残端保留自体腘绳肌腱重建术对膝关节功能、稳定性及本体感觉影响。方法选取2017年1月至2020年1月在我院行关节镜下自体腘绳肌腱修复重建ACL治疗的患者98例。根据随机数字表法分为残端保留组与残端非保留组,每组各49例。采用KT-1000测试评估膝关节稳定性。采用国产持续被动运动仪进行被动重新定位测试及被动运动察觉阈值测量评估本体感觉功能。结果术后9个月,残端保留组患者Lysholm评分、Tegner膝关节运动评分与残端非保留组差异无统计学意义(P>0.05),残端保留组前后松弛度差值低于残端非保留组,差异有统计学意义(P<0.05)。术后9个月,残端保留组被动重新定位角度(15°、30°、45°)、被动运动察觉阈值(15°、30°、45°)均低于残端非保留组,差异有统计学意义(P<0.05)。结论关节镜下自体绳肌腱残端保留重建膝关节ACL近期治疗效果满意,能更好地提高术后膝关节稳定性及本体感觉功能。

Objective To investigate the effects of arthroscopic autologous hamstring reconstruction with anterior cruciate ligament(ACL)stump preservation on knee function,stability and proprioception.Methods From January 2017 to January 2020,98 patients after arthroscopic autologous hamstring repair and ACL reconstruction were selected.According to the random number table method,all cases were divided into residual reservation group(n=49)and non-reservation group(n=49).Knee stability was evaluated by KT-1000 test.A continuous passive motion instrument made in China was used to carry out passive relocation test and passive motion detection threshold measurement to evaluate knee proprioception.Results No significant differences in Lysholm and Tegner scores between the 2 groups were observed 9 months after the operation(P>0.05).Difference value of relaxation before and after surgery,passive repositioning angle(15°,30°,45°)and passive motion detection threshold(15°,30°,45°)of the residual reservation group were lower than that of the non-reservation group 9 months after the operation(P<0.05).Conclusions Arthroscopic autologous hamstring reconstruction with anterior cruciate ligament stump preservation achieves satisfactory short-term effects,which will improve the knee stability and proprioception.