早期或晚期行关节镜下前交叉韧带重建的临床疗效对比  

Comparison of clinical effects of arthroscopic anterior cruciate ligament reconstruction in early or late stage

作　　者：黄晖[1] 王玮[1] 莫洪耀[1] HUANG Hui;WANG Wei;MO Hong-yao(Department of Orthopaedics,the Affiliated Minzu Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属民族医院骨科,南宁530021

出　　处：《骨科》2018年第6期429-433,共5页ORTHOPAEDICS

摘　　要：目的对比早期或晚期行关节镜下前交叉韧带(anterior cruciate ligament, ACL)重建的临床疗效。方法选取2015年1月至2016年11月在我院进行关节镜下单束自体腘绳肌腱重建手术治疗ACL的34例病人进行回顾性分析。其中伤后2周内进行重建手术治疗的17例纳入早期重建组,伤后2～6个月内进行重建治疗的17例纳入晚期重建组,对比两组病人的术后疼痛消除时间、肿胀消除时间和关节恢复正常活动的时间等一般临床指标,收集并比较其术前和术后18个月的Lysholm评分、术前国际膝关节文献委员会(the international knee documentation committee, IKDC)膝关节评分。结果两组病人的手术时间、术中出血量比较,差异均无统计学意义(P均>0.05);早期重建组的术后疼痛消除时间、肿胀消除时间和关节恢复正常活动时间分别为(34.06±3.27)d、(13.71±2.36)d和(50.18±4.65)d,均显著高于晚期重建组的[(25.29±3.96)d、(9.29±2.91)d和(33.41±3.48)d]差异均有统计学意义(t=7.033,t=4.850,t=1.892,P均<0.001);术后18个月,早期重建组的Lysholm评分和IKDC评分分别为(89.00±5.83)分、(90.06±5.03)分,与晚期重建组的(90.94±5.55)分、(91.47±4.23)分相比,差异均无统计学意义(P均>0.05),且两组病人Lysholm量表各单项评分之间的差异也无统计学意义(P均>0.05)。结论早期或晚期关节镜下单束自体腘绳肌腱重建手术治疗膝关节ACL损伤的近期临床疗效相近,但晚期重建治疗病人的术后恢复较快。Objective To compare the clinical outcome of anterior cruciate ligament （ACL） reconstruction by arthroscopy in early or late stage. Methods Retrospective analysis was performed on 34 patients who were treated by arthroscopic reconstruction of a single autologous hamstring tendon in our hospital from January 2015 to November 2016. Seventeen patients were treated within two weeks after the injury as early group, and others were treated from 2 months to 6 months after the injury as late group. The pain relief time,swelling elimination time, and time of joint recovery were compared. The knee joint function in the two groups was assessed by Lysholm and IKDC scales before and 18 months after surgery. Results The operation time and intraoperation blood loss between two groups had no significant differences. The pain relief time, swelling elimination time, and joint recovery time in the early group were （34.06±3.27）, （13.71±2.36） and （50.18±4.65） days respectively, which were significantly longer than that in the late group[（25.29±3.96）, （9.29±2.91） and （33.41±3.48） days], P〈0.001. The scores of Lysholm and IKDC in early group were 89.00±5.83 and 90.06±5.03 respectively, which were not significantly different from those in the late group 90.94±5.55 and 91.47± 4.23, P〉0.05. There were no significant differences between the two groups in the individual scores of Lysholm （P〉0.05）. Conclusion The clinical efficacy of ACL reconstruction by arthroscopy in early or late stage was similar, but patients who were given late reconstruction may recover faster after reconstruction.

关 键 词：前交叉韧带 关节镜检查 自体腘绳肌腱 重建 

分 类 号：R687.4[医药卫生—骨科学]