保留残端前交叉韧带重建对膝关节本体感觉恢复的影响临床研究  

Comparative Analysis on the Recovery of Proprioception from Arthroscopic Anterior Cruciate Ligament Reconstruction with or without Remnant Preservation

作　　者：张其亮[1] 赵蕾[1] 滕学仁[1] 

机构地区：[1]青岛市市立医院(东院区)骨科,山东青岛266071

出　　处：《中国运动医学杂志》2015年第8期739-743,共5页Chinese Journal of Sports Medicine

摘　　要：目的:观察关节镜下保留残端与非保留残端前交叉韧带(ACL)重建对膝关节本体感觉恢复的影响。方法:选择2012年2月至2013年10月期间行关节镜下ACL重建的患者136例为研究对象。将患者随机分为两组,每组68例,分别行保留残端重建及非保留残端重建。两组患者均选择自体半腱股薄肌腱为移植物。术前及术后3、6、9、12个月采用Lysholm评分评价膝关节的主观感觉及基本运动能力;采用被动活动察觉阈值、被动角度再生试验评估患者膝关节的本体感觉。比较分析两组患者的差异及患侧与健侧肢体的差异。结果:术后有104例患者获得12个月以上随访,平均随访时间19.75±6.21个月,其中保留残端组55例,非保留残端组49例。两组患者术后3、6、9及12个月的Lysholm评分显著高于术前(P<0.01),被动活动察觉阈值、被动角度再生试验显著低于术前(P<0.01)。术后3个月及6个月保留残端组膝关节的Lysholm评分高于非保留残端组(P<0.05),被动活动察觉阈值、被动角度再生试验低于非保留残端组(P<0.05)。术后3、6、9及12个月保留残端组患者被动活动察觉阈值、被动角度再生试验与健侧未见明显差异(P>0.05),术后3个月、6个月非保留残端组患者被动活动察觉阈值、被动角度再生试验高于健侧(P<0.05)。结论:ACL保残重建有利于患者术后膝关节功能及本体感觉的早期恢复。Objective To compare the recovery of proprioception from arthroscopic ACL reconstruction with or without remnant preservation. Methods From February 2012 to October 2013,136 patients with ACL injury in our hospital received arthroscopic ACL reconstruction. 104 of the 136 patients were followed-up for more than 12 months with an average of 19.75 4- 6.21 months,and were divided into preserving-remnant group （n= 55）and removing-remnant group （n=49）. Lysholm Scale ,regeneration test of passive angle and threshold to detection of passive motion （Tl＇DPM）were observed before and 3,6,9 and 12 months after the surgery. The comparative analysis on the data obtained was carried out between the two groups and between the injured and uninjured limbs. Results Comparing to before the surgery,the Lysholm Scale 3,6,9 and 12 months after the surgery improved significantly （P〈0.01）,and the results of passive angle reproduction test and TrDPM 3,6,9 and 12 months after the surgery decreased significantly in both groups （P〈0.01）. The results of passive angle reproduction test and TYDPM of the injured limb were significantly higher than the uninjured limb in the removing-remnant group 3 and 6 months after the surgery （P〈0.05）. Conclusion ACL reconstruction with remnant preservation is beneficial to the recovery of the proprioception after the surgery.

关 键 词：前交叉韧带重建 残端保留 本体感觉 关节镜 

分 类 号：R687.4[医药卫生—骨科学]