前交叉韧带保残单束解剖重建有利于本体感觉功能的恢复

Single-bundle anatomical reconstruction of the anterior cruciate ligament with residual ligament stump is beneficial to the recovery of proprioception

背景:前交叉韧带断裂后,膝关节本体感觉功能会受到损伤,从而影响到膝关节的稳定性,通过手术重建前交叉韧带是目前的主要治疗方法,不同的重建方式术后患者本体感觉功能恢复有所差异。目的:探讨关节镜下前交叉韧带保残单束解剖重建术后膝关节本体感觉功能的恢复情况。方法:选择昆明医科大学第一附属医院运动医学科2015年1月至2018年12月收治符合纳入标准的前交叉韧带断裂患者70例,随机分为2组,试验组保留原韧带残端解剖单束重建前交叉韧带,对照组不保留残端解剖单束重建前交叉韧带。术后通过Lysholm评分、国际膝关节文献委员会评分、被动活动察觉阈值评估两组患者膝关节功能及本体感觉恢复的情况。所有入组患者均签署相关知情同意书,试验方案经昆明医科大学第一附属医院伦理委员会通过。结果与结论:(1)术后3,6个月试验组的Lysholm评分、国际膝关节文献委员会评分较对照组高,被动活动察觉阈值较对照组低,差异有显著性意义(P<0.05);(2)术后12个月两组各项评分差异不大,差异无显著性意义(P>0.05);(3)提示保残单束解剖重建前交叉韧带有利于患者早期本体感觉功能及膝关节稳定性恢复。

BACKGROUND:After an anterior cruciate ligament rupture,the proprioception of the knee joint will be damaged,which thereby impacts the stability of the knee joint.Reconstruction of the anterior cruciate ligament through surgery is the current main treatment method;however,the recovery of proprioception of patients undergoing different reconstruction surgeries is different after different reconstruction methods.OBJECTIVE:To investigate the recovery of proprioceptive function of the knee joint after the single-bundle anatomical reconstruction of the anterior cruciate ligament with residual stump under arthroscope.METHODS:Seventy patients with anterior cruciate ligament rupture who were admitted at the Department of Sports Medicine,the First Affiliated Hospital of Kunming Medical University from January 2015 to December 2018 and met the selection criteria were enrolled and randomly divided into two groups.In the experimental group,the anterior cruciate ligament was reconstructed through a single-bundle anatomy with residual stump,while in the control group the anterior cruciate ligament was reconstructed through a single-bundle anatomy without residual stump.After operation,the Lysholm score,International Knee Documentation Committee score,and threshold to detection of passive motion were used to evaluate the knee joint function and proprioception recovery of the patients.All enrolled patients signed the relevant informed consent forms,and the trial protocol was approved by the Ethics Committee of the First Affiliated Hospital of Kunming Medical University.RESULTS AND CONCLUSION:At 3 and 6 months after operation,the Lysholm score and International Knee Documentation Committee score in the experimental group were significantly higher than those in the control group,and the threshold to detection of passive motion was significantly lower than that in the control group(P<0.05).There was no significant difference in these scores between the two groups at 12 months after operation(P>0.05).To conclude,single-bundle anatomical reconstruction of the anterior cruciate ligament with residual stump is beneficial to the early recovery of proprioception and stability of the knee joint.