全镜下前交叉韧带保残全内重建技术治疗训练致前交叉韧带损伤的近期疗效

Short-term effect of total endoscopic anterior cruciate ligament(ACL)salvage and all-inside reconstruction technique in the treatment of military training-related ACL injuries

目的探讨前交叉韧带保残全内重建技术治疗训练致膝关节前交叉韧带损伤的近期疗效。方法回顾性分析2020年1月—2021年4月经北部战区总医院诊治的28例训练致前交叉韧带损伤的军人,男性23例,女性5例;平均年龄(26.3±6.4)岁。均于北部战区总医院行韧带保残全内重建手术。比较术前及术后6、12个月的膝关节Lysholm评分、国际膝关节文献委员会(IKDC)评分、膝关节活动度(ROM)和VAS,综上评估保残全内重建技术治疗前交叉韧带损伤的临床疗效。结果全部病例术后随访13.2~14.6(平均13.6)个月。术后6、12个月Lysholm评分(分,术前vs.术后6个月vs.术后12个月:64.6±3.2 vs.82.1±6.7 vs.90.0±10.1)、IKDC评分(分,67.6±3.9 vs.80.3±7.3 vs.88.9±9.0)、膝关节ROM(99.0°±7.3°vs.113.3°±9.5°vs.120.0°±6.8°)、VAS(分,4.5±1.0 vs.1.9±0.8 vs.0.8±0.7)与术前比较差异有统计学意义(P<0.05)。病例随访期间均未出现手术相关严重不良反应。结论保残全内重建技术治疗前交叉韧带损伤临床疗效满意,短期(术后1年)膝关节疼痛及功能改善明显。

Objective To explore the short-term effect of anterior cruciate ligament(ACL)salvage and all-inside reconstruction technique in the treatment of military training-related ACL injuries.Methods A retrospec-tive analysis was conducted on 28 cases of ACL injury following military training,who were treated at the General Hospital of Northern Theater Command from Jan.2020 to Apr.2021 by ACL salvage and all-inside reconstruction technique.There were 23 males and 5 females with an average age of(26.3±6.4)years.The knee Lysholm score,International Knee Documentation Committee(IKDC)score,knee range of motion(ROM)and VAS scores before,6 and 12 months after surgery were compared to evaluate the treatment outcomes.Results All the patients were followed up for 13.2-14.6(mean 13.6)months.At postoperative 6 and 12 months,the Lysholm score(82.1±6.7,90.0±10.1),IKDC score(80.3±7.3,88.9±9.0),knee ROM(113.3°±9.5°,120.0°±6.8°),VAS score(1.9±0.8,0.8±0.7)were all significantly improved or reduced,compared with that before surgery(Lysholm score 64.6±3.2,IKDC score 67.6±3.9,knee ROM 99.0°±7.3°,VAS score 4.5±1.0,all P<0.05).No serious surgery-related adverse reaction was reported during the follow-up period.Conclusion The short-term treatment outcome of ACL salvage and all-inside reconstruction technique in the treatment of ACL injuries is satisfactory:the pain is signifi-cantly reduced and function significantly improved at one year after surgery.