保留残端解剖单束重建对前交叉韧带损伤患者术后患膝本体感觉和关节功能恢复的影响

Effect of anatomical single-bundle reconstruction with remnant preservation on postoperative knee proprioception and joint function recovery in patients with anterior cruciate ligament injury

目的:探讨保留残端解剖单束重建对前交叉韧带损伤(ACL)患者术后患膝本体感觉和关节功能恢复的影响。方法:选取82例行ACL重建术的患者为研究对象,按照治疗方案不同分为观察组和对照组,每组各41例。观察组行保留残端ACL重建术;对照组行常规不保留残端ACL重建术。记录两组患者手术一般情况;采用Lysholm评分、国际膝关节文献委员会(IKDC)评分对患者膝关节功能进行评估;并通过测定膝关节角度重现、被动活动察觉阈值来评估患者本体感觉功能恢复情况。结果:两组患者手术时间、移植物直径等一般资料无统计学差异(P>0.05)。术后3个月及6个月,相比对照组,观察组Lysholm评分更高(P<0.05),膝关节角度重现、被动活动察觉阈值均小于对照组(P<0.05);术后12个月,两组患者Lysholm评分、膝关节角度重现、被动活动察觉阈值均无统计学差异(P>0.05)。结论:ACL患者行保留残端解剖单束重建对其本体感觉功能恢复有积极作用,能够改善早期膝关节功能。

Objective:To investigate the effect of anatomical single-bundle reconstruction with remnant preservation on the recovery of knee proprioception and joint function in patients with anterior cruciate ligament(ACL)injury.Methods:A total of 82 patients who underwent ACL reconstruction were included.Among them,41 patients underwent ACL reconstruction with remnant preservation(observation group)and 41 patients underwent conventional ACL reconstruction without remnant preservation(control group).The general conditions of the two groups were recorded.Lysholm score and International Knee Documentation Committee(IKDC)score were used to evaluate the knee function of the patients.The recovery of proprioceptive function was evaluated by measuring the knee joint angle reappearance and passive activity detection threshold.Results:There was no significant difference in the operation time and graft diameter between the two groups(P>0.05).Compared with the control group,the Lysholm score of the observation group was higher at 3 and 6 months after operation(P<0.05).At 3 and 6 months after operation,the knee joint angle recurrence and passive activity detection threshold in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the two indexes between the two groups at 12 months after operation(P>0.05).Conclusion:Anatomic single-bundle reconstruction with remnant preservation in patients with ACL has a positive effect on the recovery of proprioception function and can improve early knee function.