三种手术时机下行关节镜下前交叉韧带重建术后膝关节功能和稳定性的对比研究

Comparative Study of Knee Joint Function and Stability after Arthroscopic Anterior Cruciate Ligament Reconstruction under Three Surgical Opportunities

目的:探究三种手术时机下行关节镜下前交叉韧带重建术后的膝关节功能和稳定性。方法:将2020年7月—2022年1月吉安市中心人民医院骨科收治的96例前交叉韧带损伤患者作为研究对象,按照其受伤至接受手术的时间分为早期组(n=36,受伤到接受手术的时间≤3周)、中期组(n=32,受伤到接受手术的时间>3周且≤4周)及晚期组(n=28,受伤到接受手术的时间>4周)。三组患者均由同一组具备丰富临床经验的团队完成关节镜下前交叉韧带重建术。比较三组术前、术后6个月的膝关节功能、膝关节稳定性和活动度,比较三组术后并发症发生情况。结果:术后6个月,早期组IKDC膝关节主观评价表评分、Lysholm膝关节评分、Tegner膝关节运动评分和膝关节活动度均大于中期组、晚期组,差异均有统计学意义(P<0.05)。术后6个月,早期组Lachman试验阳性率和前抽屉试验阳性率均小于晚期组,差异均有统计学意义(P<0.05)。早期组术后并发症发生率低于晚期组,差异有统计学意义(P<0.05)。结论:关节镜下前交叉韧带重建术尽可能早期实施,对患者术后膝关节功能的恢复和稳定性的提升均有积极作用,且可降低术后并发症的发生。

Objective:To explore the knee joint function and stability after arthroscopic anterior cruciate ligament reconstruction under three surgical opportunities.Method:A total of 96 patients with injury of anterior cruciate ligament admitted to the Department of Orthopedics of Ji’an Central People's Hospital from July 2020 to January 2022 were selected as the research objects.According to the time from injury to surgery,they were divided into early group(n=36,the time from injury to surgery≤3 weeks),middle group(n=32,the time from injury to surgery>3 weeks and≤4 weeks)and late group(n=28,the time from injury to surgery>4 weeks).All the three groups of patients completed arthroscopic anterior cruciate ligament reconstruction by the same team with rich clinical experience.The knee joint function,knee joint stability and range of motion before and 6 months after surgery were compared among the three groups,and the incidence of postoperative complications were compared among the three groups.Result:6 months after surgery,the international knee documentation committee knee evaluation fore scores,Lysholm knee joint scores,Tegner knee joint motor scores and knee joint range of motion in the early group were higher than those in the middle and late groups,the differences were statistically significant(P<0.05).6 months after surgery,the positive rates of Lachman test and anterior drawer test in the early group were lower than those in the late group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in early group was lower than that in late group,the difference was statistically significant(P<0.05).Conclusion:Arthroscopic anterior cruciate ligament reconstruction performed as early as possible has a positive effect on the recovery of postoperative knee joint function and the improvement of stability,and can reduce the occurrence of postoperative complications.