镜下保残与标准重建对前交叉韧带损伤患者的影响

Influence of arthroscopic remnant preservation and standard reconstruction on patients with anterior cruciate ligament injury

目的:比较镜下保残与标准重建对前交叉韧带损伤患者的影响。方法:将132例前交叉韧带损伤患者依据手术方式不同分为观察组(关节镜下保残重建,n=66)与对照组(标准重建,n=66)。比较两组患者临床相关指标(手术时间、出血量、住院时间、术后恢复时间、住院费用)。于术前及术后12个月比较膝关节本体感觉功能[被动活动察觉阈值(TDPM)]、膝关节功能、膝关节稳定性,于术后12个月比较影像学参数(股骨及胫骨隧道位置、骨隧道扩大情况)。结果:观察组住院费用高于对照组(P<0.05);术中出血量、术后恢复时间、住院时间少于对照组(P<0.05)。两组患者手术时间无统计学差异(P>0.05);术后12个月,两组Lysholm评分、IKDC评分、TDPM值及影像学相关参数均无统计学差异(P>0.05)。结论:关节镜下保残重建的术中出血量、术后恢复时间、住院时间均低于标准重建术式,二者对前交叉韧带损伤患者疗效与安全性相当。

Objective:To compare the influence of arthroscopic remnant preservation and standard reconstruction on patients with anterior cruciate ligament(ACL)injury.Methods:132 patients with ACL injury were divided into observation group(arthroscopic reconstruction with remnant preservation,n=66)and control group(standard reconstruction,n=66)by different surgical methods.The clinical related indicators(surgical time,blood loss,hospital stay,postoperative recovery time,hospitalization expenditure),knee proprioception function[threshold to detect passive motion(TDPM)],knee function and knee stability before surgery and at 12 months after surgery and imaging parameters(femoral and tibial tunnel positions,bone tunnel enlargement status)at 12 months after surgery were compared between both groups.Results:Hospitalization expenditure in observation group was higher than that in control group(P<0.05),while intraoperative blood loss,postoperative recovery time and hospital stay were lower or shorter than those in control group(P<0.05).No obvious differences in surgical time and Lysholm score,IKDC score,TDPM value and imaging related parameters at 12 months after surgery were shown between the two groups(P>0.05).Conclusion:There are no significant differences in efficacy and safety between arthroscopic reconstruction with remnant preservation and standard reconstruction for patients with ACL injury,and the intraoperative blood loss,postoperative recovery time and hospital stay of the former one are less or shorter than those of the latter one.