关节镜下单纯修复技术与增强修复技术治疗慢性踝关节外侧不稳的疗效研究

Study on efficacy of arthroscopic simple repair technique and enhanced repair technique in treating chronic ankle instability

目的探讨关节镜下外踝韧带单纯修复技术与增强修复技术在治疗慢性踝关节外侧不稳(CLAI)中的临床疗效。方法选取2018年1月至2019年1月经中国人民解放军北部战区总医院诊治的CLAI患者41例,均在关节镜下行外踝韧带单纯修复或增强修复治疗。39例患者随访资料完整,其中18例行关节镜下带线锚钉修复距腓前韧带(ATFL),纳入单纯修复组;21例行关节镜下带线锚钉和无结锚钉增强修复ATFL,纳入增强修复组。术后随访12个月,比较两组术前和术后第3、6、12个月的视觉模拟疼痛量表(VAS)评分和美国足与踝关节协会(AOFAS)踝-后足评分,评价两种手术方式在CLAI治疗中的疗效。结果两组患者术前VAS评分和AOFAS踝-后足评分组间比较差异无统计学意义(P>0.05);术后各观察时间点增强修复组VAS评分与修复组比较,差异无统计学意义(P>0.05),AOFAS踝-后足评分均高于单纯修复组,差异有统计学意义(P<0.05)。随访期间均未出现严重并发症。结论从疼痛和踝关节功能上,关节镜下增强修复技术治疗CLAI效果总体优于单纯修复技术。

Objective To investigate the clinical efficacy of arthroscopic simple repair technique and enhanced repair technique in the treatment of chronic lateral ankle instability(CLAI).Methods Forty-one cases of CLAI treated in the General Hospital of Northern Theater Command of PLA from January 2018 to January 2019 were selected and conducted arthroscopic lateral ankle ligament repair or enhanced repair treatment.The follow up data in 39 cases were complete.Among them,18 cases conducted the anterior talofibular ligament repair with wire anchor under arthroscopy and were included in the repair group,while 21 cases conducted the arthroscopic enhanced repair with linear anchors and knots free anchors and were included in the enhanced repair group.The postoperative follow up lasted for 12 months.The VAS score and AOFAS ankle-hind foot score before operation and in postoperative,3,6,12 months were compared between the two groups.The efficacies of treating CLAI by the two operation modes were evaluated.Results The preoperative VAS score and AOFAS ankle-hind foot score had no statistical differences between the two groups(P>0.05).The VAS score at postoperative time points had no statistical difference between the enhanced repair group and repair group(P>0.05).The AOFAS ankle-hind foot score in the enhanced repair group was higher than that in the repair group,and the difference was statistically significant(P<0.05).No serious complications occurred in the grouped patients during the follow up period.Conclusion In terms of pain and ankle function,the effect of arthroscopic enhanced repair in treating CLAI is better than that of simple repair.