关节镜下保留前内侧束残端重建前交叉韧带的疗效

The effect of anterior cruciate ligament reconstruction with preserving anteromedial bundle stump under arthroscopy

目的探讨关节镜下保留膝关节前内侧束残端行前交叉韧带(ACL)重建的临床效果。方法采用关节镜下保留膝关节前内侧束残端行ACL重建治疗49例ACL不全断裂患者。采用膝关节Lysholm评分和IKDC评分评价术后膝关节活动功能。通过手术前后被动角度再生试验评估本体感觉的恢复,计算测定现有角度与患者感知角度之间的差值(JPS)。结果患者均获得1年随访。膝关节IKDC评分及Lysholm评分术后3、6、12个月均高于术前,差异均有统计学意义(P<0.05)。患膝术前及术后本体感觉测试:患膝在屈曲20°、50°、80°时,JPS术后3、12个月均较术前明显好转(P<0.05),术后12个月与术后3个月比较差异均无统计学意义(P>0.05);术后3、12个月,在各屈曲活动度上JPS患膝与健侧比较差异均无统计学意义(P>0.05)。结论关节镜下保留前内侧束残端重建ACL治疗ACL不全断裂患者可获得良好的临床效果。

Objective To investigate the clinical effect of anterior cruciate ligament(ACL)reconstruction with preserving anteromedial bundle stump of the knee under arthroscopy.Methods A total of 49 patients with ACL incomplete ruptures were reconstructed by preserving the anteromedial bundle stump of knee under arthroscopy.Lysholm score and IKDC score of knee joint were used to evaluate the postoperative knee mobility function.Recovery of proprioception was assessed by pre-and post-operative passive angle regeneration test,and the difference between the existing angle and the patient′s perceived angle(JPS)was calculated and measured.Results All patients were followed up for 1 year.At 3,6 and 12 months after surgery,IKDC score and Lysholm score of the Knee were higher than those before surgery,and the differences were statistically significant(P<0.05).The proprioception test of the affected knee at pre-and post-operation:flexion at 20°,50°and 80°,the JPS were significantly improved at 3,12 months postoperation than the preopeation(P<0.05),there was no significant difference between 12 months after surgery and 3 months after surgery(P>0.05);at 3,12 months postoperation,the differences of JPS between the affected side and the healthy side had no differences at the various flexion angles(P<0.05).Conclusions It can obtain good effect that arthroscopy preserving anteromedial bundle stump is used to reconstruct ACL in patients with incomplete ACL rupture.