不同入路定位胫骨隧道重建后交叉韧带效果对比

Comparison of Different Approaches for Tibial Tunnel Posterior Cruciate Ligament Reconstruction

目的 分析不同入路定位胫骨隧道重建后交叉韧带的效果。方法 非随机选取2021年1月—2023年6月钦州市中医医院骨科收治的50例后交叉韧带损伤患者为研究对象。根据手术方式不同,分为观察组和对照组,每组25例。观察组患者接受前方高位双入路手术,对照组患者接受三入路手术。对比两组手术相关指标、并发症、下地行走时间、住院时间。结果 观察组手术时间、切口总长度、术中失血量、术中透视次数优于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症总发生率低于对照组,差异无统计学意义(P>0.05)。观察组患者下地行走时间为(6.05±0.04)周、住院时间为(5.35±1.12)d,短于对照组的(6.64±0.07)周、(6.89±1.46)d,差异有统计学意义(t=6.598、3.274,P均<0.05)。结论 双入路和三入路定位胫骨隧道重建后均不易引起术后并发症,双入路法操作更加简捷,切口更小,可减少患者术中失血量和透视次数,术后患者可在短时间内下地行走。

Objective To analyze the effectiveness of different access routes to locate the tibial tunnel for reconstruction of the posterior cruciate ligament.Methods Fifty patients with posterior cruciate ligament injuries admitted to the Department of Orthopedics of Qinzhou Hospital of Traditional Chinese Medicine from January 2021 to June 2023 were non-randomly selected as study subjects.According to the different surgical methods,they were divided into observation group and control group,with twenty-five cases in each group.The patients in the observation group received anterior high double-entry surgery,and the patients in the control group received triple-entry surgery.Surgery-related indexes,complications,walking time and hospitalization time were compared between the two groups.Results The observation group′s operation time,total length of incision,intraoperative blood loss,and number of intraoperative fluoroscopies were better than those of the control group,and the differences were statistically significant(all P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was not statistically significant(P>0.05).The time for patients in the observation group to walk down to the ground was(6.05±0.04)weeks and the hospitalization time was(5.35±1.12)d,which was shorter than(6.64±0.07)weeks and(6.89±1.46)d in the control group,and the differences were statistically significant(t=6.598,3.274,both P<0.05).Conclusion Both dual-and triple-entry positioning of the tibial tunnel reconstruction are less likely to cause postoperative complications. The dual-entry method is more concise, with a smaller incision, which reduces intraoperative blood loss and the number of fluoroscopies in the patient, and allows the patient to get down to the ground in a short period of time after surgery.