外伤性膝内侧副韧带损伤直接缝合与带线锚钉缝合比较分析  

Comparative analysis of direct suture and suture anchor suture for traumatic medial collateral ligament injury of knee

作　　者：任海鹏 陈刚 蔡明[2] REN Hai-peng;CHEN Gang;CAI Ming(Department of Orthopedics,Minhang District Integrated Traditional Chinese and Western Medicine Hospital,Shanghai 200241,China;Department of Orthopedics,Shanghai Tenth People's Hospital Affiliated to Tongji University,Shanghai 200072,China)

机构地区：[1]上海市闵行区中西医结合医院骨科,上海200241 [2]同济大学附属上海第十人民医院骨科,上海200072

出　　处：《生物医学工程与临床》2019年第4期422-426,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨外伤性膝内侧副韧带损伤直接缝合与带线锚钉缝合的临床疗效。方法选择2014年7月至2017年7月上海市闵行区中西医结合医院诊治的68例外伤性膝内侧副韧带损伤患者,其中男性40例,女性28例;年龄20~41岁,平均年龄27.96岁。根据缝合方式将其分为2组,其中直接缝合组38例(38膝),带线锚钉缝合组30例(30膝)。比较两组患者围手术期相关指标、术后1年膝关节功能及稳定性情况。结果带线锚钉缝合组手术时间和术中出血量明显低于直接缝合组,但治疗费用明显高于直接缝合组,差异有统计学意义(P<0.05)。两组患者术后均未出现明显的切口愈合不良、切口感染等并发症。两组患者术后1年时国际膝关节文献委员会(IKDC)膝关节量表评分、Lysholm评分均高于术前[直接缝合组(88.24±1.28)分vs(54.34±4.54)分,(87.28±2.37)分vs(41.65±2.38)分;带线锚钉缝合组(94.12±1.34)分vs(54.57±4.28)分,(92.65±1.25)分vs(42.35±2.64)分];带线锚钉缝合组患者术后1年IKDC膝关节量表评分、Lysholm评分显著高于直接缝合组,差异均有显著统计学意义(P<0.01)。两组患者术后1年Lysholm试验和Pivotshift试验阳性率均明显低于术前[直接缝合组15.79%vs100.00%,18.42%vs100.00%;带线锚钉缝合组0.00%vs100.00%,0.00%vs100.00%];直接缝合组术后1年的Lysholm试验和Pivot-shift试验阳性率高于带线锚钉缝合组,差异有统计学意义(P<0.05)。结论带线锚钉治疗外伤性膝内侧副韧带损伤能够使受损膝关节获得满意的稳定性和功能,术后恢复快,若患者经济条件允许,优先推荐使用带线锚钉修复外伤性膝内侧副韧带损伤。Objective To detect the clinical effect of direct suture for traumatic medial collateral ligament injury and suture anchor suture.Methods From July 2014 to July 2017,a total of 68 patients with traumatic medial collateral ligament injury were enrolled,which included 40 males and 28 females,aged 20 - 41 years old with mean age of 27.96 years old.According to suture method,all of them were divided into direct suture group(n = 38) and suture anchor suture group(n = 30) by suture method. The perioperative related indicators,the knee joint function and stability 1-year post-operation between 2 groups were compared. Results The operation time and intraoperative blood loss of suture anchor suture group were significantly lower than those of direct suture group,but the cost was significantly higher than that of direct suture group.The difference was statistically significant(P < 0.05).There were no obvious complications such as poor healing of incision and infection of incision in 2 groups. The International Knee Documentation Committee(IKDC) knee joint scale score 1-year post-operation were higher than before operation[direct suture group was (88.24 ± 1.28) scores vs (54.34 ± 4.54) scores,(87.28 ± 2.37) scores vs (41.65 ± 2.38) scores;suture anchor suture group was (94.12 ± 1.34) scores vs (54.57 ± 4.28) scores,(92.65 ± 1.25) scores vs (42.35 ± 2.64) scores];The IKDC knee joint scale score and Lysholm score 1-year post-operation of suture anchor suture group were statistically significantly higher than those in direct suture group(P < 0.01);The positive rate of Lysholm test and Pivot-shift test after operation were significantly lower than those of before operation in 2 groups(direct suture group was 15.79 % vs 100.00 %,18.42 % vs 100.00 %;suture anchor suture group was 0.00 % vs 100.00 %,0.00 % vs 100.00 %).The positive rates of Lysholm test and Pivot-shift test in direct suture group were statistically significant higher than those in suture anchor suture group after treatment for 1-year(P < 0.05).Conclusion I

关 键 词：膝关节内侧副韧带 韧带损伤 直接缝合 带线锚钉缝合 临床疗效 

分 类 号：R684.7[医药卫生—骨科学]