韧带倾斜角及胫股关节角度变化与前交叉韧带重建关节功能的关系及影响因素

The relationship and influencing factors between changes in ligament inclination angle and tibiofemoral joint angle with anterior cruciate ligament reconstruction joint function

目的:探讨韧带倾斜角及胫股关节角度变化与前交叉韧带重建关节功能的关系及影响因素。方法:选取2021年3月至2023年3月在洛阳正骨医院膝关节中心进行前交叉韧带重建治疗的患者102例,根据术后6个月国际膝关节文献委员会(international knee joint literature committee,IKDC)评分情况分为关节功能恢复良好患者72例和关节功能恢复不良患者30例,比较恢复良好和不良患者临床资料、韧带倾斜角及胫股关节角度变化,并分析与前交叉韧带重建关节功能的关系及其影响因素。结果:关节功能恢复不良患者女性比例、年龄≥40岁比例、生活意外比例分别为56.67%、60.00%和73.33%,明显高于关节功能恢复良好患者(P<0.05);关节功能恢复不良患者前交叉韧带冠状位、矢状位倾斜角手术前后变化值分别为(16.78±1.88)°和(16.20±1.82)°,明显高于恢复良好患者(P<0.05);关节功能恢复良好和不良患者胫股关节角度手术前后变化值比较差异无统计学意义(P>0.05);前交叉韧带冠状位、矢状位倾斜角手术前后变化值与IKDC评分呈负相关(r=-0.399;-0.454,P<0.05);胫股关节角度手术前后变化值与IKDC评分无明显相关性(P>0.05);Logistic回归分析结果显示:年龄、前交叉韧带冠状位倾斜角手术前后变化值、前交叉韧带矢状位倾斜角手术前后变化值是患者关节功能恢复的影响因素(P<0.05)。结论:年龄及韧带倾斜角手术前后变化值是前交叉韧带重建关节功能的影响因素,胫股关节角度变化与关节功能恢复无明显相关性。

Objective:To explore the relationship and influencing factors between changes in ligament inclination angle and tibiofemoral joint angle with anterior cruciate ligament reconstruction joint function.Methods:102 patients with anterior cruciate ligament reconstruction who were treated at the knee joint center of Luoyang Orthopedic Hospital from March 2021 to March 2023 were selected,All patients underwent anterior cruciate ligament reconstruction treatment.According to the International Knee Joint Literature Committee(IKDC)score at 6 months post surgery,there were 72 patients with good joint function recovery and 30 patients with poor joint function recovery.The clinical data and so on of patients with good and poor joint function recovery were compared.Results:The proportion of women,the proportion of age≥40 years old,and the proportion of life accidents in patients with poor joint function recovery were 56.67%,60.00%,and 73.33%,respectively,which were significantly higher than those of patients with good joint function recovery(P<0.05).The preoperative and postoperative changes in the anterior cruciate ligament tilt angle in coronal and sagittal positions in patients with poor joint function recovery were(16.78±1.88)°and(16.20±1.82)°,respectively,which were significantly higher than those in patients with good recovery(P<0.05).There was no statistically significant difference in the changes in tibiofemoral joint angle before and after surgery between patients with good and poor joint function recovery(P>0.05).The preoperative and postoperative changes in the inclination angle of the anterior cruciate ligament in coronal and sagittal positions were negatively correlated with the IKDC score(r=-0.399 and-0.454,P<0.05).There was no significant correlation between the changes in tibiofemoral joint angle before and after surgery and the IKDC score(P>0.05).Logistic regression analysis showed that age,changes in anterior cruciate ligament coronal tilt angle before and after surgery,and changes in anterior cruciate ligament sagittal tilt angle before and after surgery were the influencing factors for joint function recovery in patients(P<0.05).Conclusion:Age and the change in ligament inclination angle before and after surgery is a factor affecting joint function after anterior cruciate ligament reconstruction,while there is no significant correlation between changes in tibiofemoral joint angle and joint function recovery.