伴内侧副韧带断裂的前交叉韧带损伤患者两种修复方式效果对比分析

Comparative Analysis of the Effects of Two Repair Methods in Patients with Anterior Cruciate Ligament Injury and Medial Collateral Ligament Rupture

目的分析两种修复方式治疗伴内侧副韧带(MCL)断裂的前交叉韧带(ACL)损伤的效果。方法以电脑随机数字表法将2021年4月至2022年11月收治的88例伴MCL断裂的ACL损伤患者分为观察组和对照组,每组44例。对照组采用腘绳肌腱与MCL止点重建,观察组采用腓骨长肌腱与MCL止点重建。比较2组手术状况、康复进程、并发症状况、膝关节功能[国际膝关节文献委员会膝关节评估表(IKDC)、Tegner评分、Lysholm评分]、膝关节稳定性、移植物磁共振成像(MRI)表现、踝关节功能[美国矫形足踝协会(AOFAS)踝-脚足评分]、足功能、步态以及并发症情况。结果观察组肌腱直径大于对照组,肌腱长度长于对照组(P<0.01)。术后6个月,观察组Lysholm评分、IKDC评分、Tegner评分高于对照组(P<0.05)。术后6、12个月,2组Lachman试验、轴移试验、应力位内侧间隙开大程度、AOFAS踝-脚足评分比较无明显差异(P>005)。术后12个月,2组移植物MRI表现、足功能、步态及并发症发生率比较无明显差异(P>0.05)。结论腓骨长肌腱、腘绳肌腱分别联合MCL止点重建治疗伴MCL断裂的ACL损伤患者在改善并发症、足踝功能等方面效果相似,但前者可改善肌腱重构,促进膝关节功能恢复。

Objective To analyze the effect of two repair methods on anterior cruciate ligament(ACL)injury with medial collateral ligament(MCL)rupture.Methods A total of 88 patients with ACL injury and MCL rupture admitted from April 2021 to November 2022 were divided into observation group(n=44)and control group(n=44)by random number ta-ble method.The control group underwent reconstruction using hamstring tendon and attachment of MCL,and the observation group underwent reconstruction using peroneal long tendon and attachment of MCL.The surgical status,recovery process,complications,knee function[International Knee Documentation Committee Knee Form(IKDC),Tegner score,Lysholm score],knee stability,graft magnetic resonance imaging(MRI),ankle function[American Orthopaedic Foot and Ankle Soci-ety(AOFAS)ankle-foot score],foot function,gait,and complications were compared between the two groups.Results The tendon diameter was larger and tendon length was greater in the observation group than in the control group(P<0.01).At 6 months after operation,Lysholm score,IKDC score and Tegner score in observation group were higher than those in control group(P<0.05).At 6 and 12 months after operation,there were no significant differences between the two groups in Lach-man test,axial shift test,medial space opening degree of stress position and AOFAS ankle-foot score(P>0.05).At 12 months after operation,there were no significant differences in MRI findings,foot function,gait and complication rate between the two groups(P>0.05).Conclusion Peroneal longus tendon and hamstring tendon combined with MCL attachment re-construction have similar effects on improving complications and ankle function in ACL patients with MCL rupture,but the for-mer can improve tendon reconstruction and promote recovery of knee function.