关节镜下三隧道重建术治疗膝关节前交叉韧带损伤的效果  

Effect of Arthroscopic Three-tunnel Reconstruction in the Treatment of Anterior Cruciate Ligament Injury of Knee Joint

作　　者：袁鹏[1] 刘宁[1] YUAN Peng;LIU Ning(Department of Sports Trauma-Arthroscopy,Zhengzhou Orthopedic Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市骨科医院运动创伤-关节镜科,河南郑州450000

出　　处：《河南医学研究》2021年第34期6378-6380,共3页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20191140)。

摘　　要：目的分析关节镜下三隧道重建术治疗膝关节前交叉韧带(ACL)损伤的效果。方法选取郑州市骨科医院2018年4月至2021年1月收治的117例ACL损伤患者作为研究对象,根据手术方案分为观察组(59例)和对照组(58例)。对照组接受ACL悬吊固定术,观察组接受关节镜下三隧道重建术。比较两组围手术期指标、疼痛程度[数字评分法(NRS)]、膝关节稳定性、膝关节功能[国际膝关节评分委员会(IKDC)量表]及实验室指标[CD44、骨桥蛋白(OPN)水平]。结果观察组首次下床时间、负重行走时间、住院时间较对照组短(P<0.05);术后3 d两组NRS评分较术前低,且观察组较对照组低(P<0.05);术后3个月两组轴移试验、拉赫曼试验、前抽屉试验阳性率均低于术前(P<0.05);术后3个月两组IKDC评分高于术前,且观察组高于对照组(P<0.05);术后3个月两组CD44、OPN水平低于术前,且观察组低于对照组(P<0.05)。结论关节镜下三隧道重建术可缩短膝关节ACL损伤患者康复进程,缓解膝关节疼痛,增强膝关节稳定性,改善膝关节功能。Objective To analyze the effect of arthroscopic three-tunnel reconstruction in the treatment of knee anterior cruciate ligament(ACL)injury.Methods A total of 117 patients with ACL injury treated in Zhengzhou Orthopedic Hospital from April 2018 to January 2021 were selected as the research objects.They were divided into observation group(59 cases)and control group(58 cases)according to the operation scheme.The control group received anterior cruciate ligament suspension fixation,and the observation group received arthroscopic three-tunnel reconstruction.The perioperative indexes,pain degree[digital scoring system(NRS)],knee stability,knee function[International Knee Documentation Committee(IKDC)scale]and laboratory indexes[CD44 and osteopontin(OPN)levels]were compared between the two groups.Results The first time out of bed,weight-bearing walking time and hospital stay of the observation group were shorter than those in the control group(P<0.05).Three days after operation,the NRS score of the two groups was lower than that before operation,and that of the observation group was lower than that of the control group(P<0.05).Three months after operation,the positive rates of axial displacement test,Rahman test and front drawer test in the two groups were lower than those before operation(P<0.05).Three months after operation,the IKDC score in the two groups was higher than that before operation,and that in the observation group was higher than that in the control group(P<0.05).Three months after operation,the levels of CD44 and OPN in the two groups were lower than those before operation,and those in the observation group were lower than those in the control group(P<0.05).Conclusion Arthroscopic three-tunnel reconstruction can shorten the rehabilitation process of patients with knee ACL injury,relieve knee pain,enhance knee stability and improve knee function.

关 键 词：前交叉韧带损伤 膝关节功能 关节镜 三隧道重建术 

分 类 号：R615[医药卫生—外科学]