完全保留残端自体腱重建后交叉韧带对本体感觉恢复的影响  

The recovery research of proprioception after the posterior cruciate ligament reconstructive operation with the stump of autoallergic tendon reserving totally

作　　者：左华[1] 黄永辉[1] 胡浪[1] 李勇[1] 

机构地区：[1]江苏大学附属医院骨二科,江苏镇江212001

出　　处：《临床骨科杂志》2014年第3期294-298,共5页Journal of Clinical Orthopaedics

基　　金：江苏大学临床医学发展基金(编号:JLY2010131)

摘　　要：目的：观察完全保留残端自体腱重建后交叉韧带（PCL）术后本体感觉恢复状况，探讨完全保留与非保留残端重建PCL对本体感觉恢复的影响。方法对40例PCL损伤的患者中20例行不保留残端自体绳肌单束重建术（非保留残端组），20例行完全保留残端自体绳肌单束重建术（完全保留残端组）。通过IKDC评分、Lysholm评分及CPM机等速测试膝关节本体感觉，评估两组患者术后本体感觉恢复状况。结果40例均获随访，时间6～24（15.6±4.945）个月。两组患者术后6、12个月膝关节IKDC评分及Lysholm评分均较术前明显改善（P＜0.05）；两组间比较差异无统计学意义（P＞0.05）。术后6个月，在3个不同的膝关节复位角度下，非保留残端组患侧膝关节与健侧比较差异有统计学意义（P＜0.05）；完全保留残端组患侧膝关节与健侧比较差异无统计学意义（P＞0.05）；两组间患侧膝关节比较差异有统计学意义（P＜0.05）。术后12个月，在3个不同的膝关节复位角度下，两组患侧膝关节与健侧比较差异均无统计学意义（P＞0.05）。两组之间患侧膝关节比较差异无统计学意义（P＞0.05）。结论完全保留残端重建PCL能够可靠地恢复膝关节的本体感觉，且早期恢复效果优于非保留残端重建PCL。Objective To observe the recovery states of proprioception after the posterior cruciate ligament recon-structive operation with the stump of autoallergic tendon reserving totally,then to observe the effects of recovery of proprioception by totally reserving and not reserving the stump of autoallergic tendon.Methods 40 patients with the posterior cruciate ligament injured were undergone reconstruction of posterior cruciate ligament of 20 patients by totally reserving stump of autoallergic tendon as the reserving group and 20 patients by not reserving the stump of autoallergic tendon as the not reserving group.The recovery states of proprioception of both group were evaluated postoperatively by IKDC scores,Lysholm scores and CPMmachine.Results All of 40 patients were followed up for 6-24（15.6 ± 4.945 ）months. IKDC scores and Lysholm scores of knee joint in two groups after operation both improved obviously at 6 months and 12 months compared with preoperation（P〈0.05）,but the differences between these two groups hadn′t statistical significance（P〉0.05 ）;The group of not reserving the stump compared with uninjured side in 3 dif-ferent embolia angles at 6 months after operation,the differences got statistical significance（P〈0.05 ）,while the to-tally reserving group compared with uninjured side,the differences didn′t get statistical significance（P〉0.05 ）,and the differences in injured side of two groups got statistical significance（P〈0.05）;At 12 months after operation,the two groups in injured side compared with uninjured side in 3 different embolia angles,the differences hadn′t statisti-cal significance（P〉0.05 ）,the injured side of two groups were compared,the differences hadn′t statistical signifi-cance（P〉0.05 ）.Conclusions Totally reserving the stump of autoallergic tendon to reconstruct the posterior cruci-ate ligament can recover the proprioception of knee joint reliably,and the effects of early recovery is good than non-reserving group.

关 键 词：后交叉韧带损伤 膝关节 本体感觉 自体腱 

分 类 号：R686.5[医药卫生—骨科学] R687.2[医药卫生—外科学]