关节镜下前交叉韧带修复术治疗膝关节轻度前向不稳临床疗效

Arthroscopic anterior cruciate ligament repair for mild anterior knee instability

目的探讨关节镜下前交叉韧带(ACL)修复术治疗膝关节轻度前向不稳的临床疗效.方法选取2020年5—12月于北部战区总医院骨科经同一运动医学专业主诊医师诊断为膝关节轻度前向不稳的21例(21膝)患者为研究对象.所有患者均进行关节镜下ACL股骨止点后外束修复术.治疗后随访1~5个月,通过Lachman试验、前抽屉试验(ADT)评估膝关节稳定性,通过IKDC 2000评分、Lysholm评分及Bristol膝关节评分评估膝关节功能.结果所有患者术后均进行了完整随访,随访时间14 d至5个月.膝关节稳定性:与术前比较,术后早期患者Lachman试验均转为阴性,ADT试验无明显改变,术后膝关节磁共振成像中ACL信号张力改善明显,走行区域信号均匀,连续性好.膝关节功能:与术前比较,术后患者IKDC2000评分、Lysholm评分、Bristol评分均明显升高,差异有统计学意义(P<0.05).所有患者术后均未发生感染、关节不稳、ACL再次撕裂等不良反应.结论关节镜下ACL股骨止点修复技术可有效改善膝关节轻度前向不稳症状,术后不良反应较少,有利于膝关节前向稳定性的早期恢复.

Objective To investigate the clinical effect of arthroscopic anterior cruciate ligament(ACL)repair in the treatment of mild forward instability of knee joint.Methods A total of 21 patients(21 knees)diagnosed with mild forward instability of the knee by the same sports medicine professional attending physician in the department of orthopedics in the General Hospital of Northern Theater Command from May to December 2020 were selected as the study subjects.All patients underwent arthroscopic posterior external band repair of the ACL femoral stop.The Lachman test and anterior drawer test(ADT)were used to evaluate knee stability, and the IKDC 2000 score, Lysholm score and Bristol knee score were used to evaluate knee function.Results All patients were followed up for 14 days to 5 months.Compared with the preoperative, Lachman test turned negative in the early postoperative period, and ADT test showed no significant change, and the ACL signal tension in postoperative knee magnetic resonance imaging was significantly improved and the walking area signal was uniform and continuous.Compared with preoperative, IKDC2000 score, Lysholm score and Bristol score were significantly increased after surgery, with statistical significance(P<0.05).All patients had no adverse reactions such as infection, joint instability and ACL retear.Conclusion Arthroscopic ACL femoral stop repair technique can effectively improve mild forward instability of the knee joint, with fewer postoperative adverse reactions, and is beneficial to the early recovery of the forward stability of the knee joint.