全关节镜下可吸收免打结线带重建在距腓前韧带损伤所致慢性踝关节外侧不稳患者中的应用效果

Effect of arthroscopic knotless absorbable suture tape reconstruction for patients with chronic lateral ankle instability caused by anterior talofibular ligament injury

目的探讨全关节镜下可吸收免打结线带重建在距腓前韧带损伤所致慢性踝关节外侧不稳患者中的应用效果。方法选取2020年1月至2023年1月聊城市第三人民医院收治的110例距腓前韧带损伤所致慢性踝关节外侧不稳患者进行随机对照试验,采用随机数字表法将其分为对照组和观察组,各55例。对照组男30例,女25例,年龄(55.48±3.57)岁。观察组男35例,女20例,年龄(56.38±2.64)岁。对照组采用传统韧带修复手术治疗,观察组采用全关节镜下可吸收免打结线带重建手术治疗。比较两组术前及术后2个月美国足踝外科协会评分(American Orthopedic Foot&Ankle Society Score,AOFAS)、Kofoed踝关节功能评分、Y平衡测试(Y balance test,YBT)及自觉踝关节稳定性量表(Perceived Ankle Instability,PAI)评分和并发症发生率、疼痛视觉模拟量表(Visual Analogue Scale,VAS)评分。采用t检验、χ^(2)检验。结果术后2个月,观察组AOFAS评分、Kofoed踝关节功能评分均高于对照组[(90.13±2.89)分比(79.27±3.28)分、(90.29±2.21)分比(78.44±2.46)分],差异均有统计学意义(t=18.424、26.575,均P<0.05);观察组YBT、PAI评分均优于对照组[(88.28±2.69)分比(78.22±1.66)分、(3.02±1.22)分比(5.34±2.30)分],差异均有统计学意义(t=23.603、6.609,均P<0.05)。观察组术后1、2个月VAS评分均低于对照组[(3.20±1.15)分比(6.89±1.26)分、(1.34±0.54)分比(4.64±1.12)分],差异均有统计学意义(t=16.041、19.683,均P<0.05)。观察组并发症发生率低于对照组[16.36%(9/55)比49.09%(27/55)],差异有统计学意义(χ^(2)=13.378,P<0.05)。结论全关节镜下可吸收免打结线带重建治疗距腓前韧带损伤所致慢性踝关节外侧不稳患者可显著改善他们的踝关节功能,提高自觉踝关节稳定性,减轻术后疼痛,减少术后并发症,具有较高的临床应用价值。

Objective To explore the effect of arthroscopic absorbable knotless suture tape reconstruction for patients with chronic lateral ankle instability caused by anterior talofibular ligament injury.Methods A total of 110 patients with chronic lateral ankle instability caused by anterior talofibular ligament injury treated in Liaocheng Third People's Hospital from January 2020 to January 2023 were selected for the randomized controlled trial,and were divided into a control group and an observation group by the random number table method,with 55 cases in each group.There were 30 males and 25 females in the control group;they were(55.48±3.57)years old.There were 35 males and 20 females in the observation group;they were(56.38±2.64)years old.The control group took traditional ligament repair surgery,and the observation group arthroscopic absorbable knotless suture tape reconstruction surgery.The American Orthopaedic Foot&Ankle Society Scores(AOFAS),Kofoed ankle function scores,and scores of Y balance test(YBT)and Perceived Ankle Instability(PAI)before and 2 months after the surgery,as well as the incidences of complications and pain scores of Visual Analogue Scale(VAS),were compared between the two groups.t andχ^(2) tests were applied.Results Two months after the surgery,the scores of AOFAS and Kofoed ankle function in the observation group were higher than those in the control group[(90.13±2.89)vs.(79.27±3.28)and(90.29±2.21)vs.(78.44±2.46)],with statistical differences(t=18.424 and 26.575;both P<0.05);the scores of YBT and PAI in the observation group were better than those in the control group[(88.28±2.69)vs.(78.22±1.66)and(3.02±1.22)vs.(5.34±2.30)],with statistical differences(t=23.603 and 6.609;both P<0.05).The scores of VAS 1 and 2 months after the surgery in the observation group were lower than those in the control group[(3.20±1.15)vs.(6.89±1.26)and(1.34±0.54)vs.(4.64±1.12)],with statistical differences(t=16.041 and 19.683;both P<0.05).The incidence of complications in the observation group was lower than that in the control group[16.36%(9/55)vs.49.09%(27/55)],with a statistical difference(χ^(2)=13.378,P<0.05).Conclusion Arthroscopic absorbable knotless suture tape reconstruction in the treatment of patients with chronic lateral ankle instability caused by anterior talofibular ligament injury can significantly improve their ankle function and perceived ankle stability and reduce postoperative pain and complications,so it has high clinical application value.