关节镜下自体腓骨长肌腱移植重建后交叉韧带的临床效果及对踝关节的影响  

Effect of arthroscopic autologous peroneus longus tendon graft to reconstruct posterior cruciate ligament and its influence on ankle joint

作　　者：王军[1] 林伟明 李向阳[1] 黄健[1] 廖红兴[1] 刘松浪 张平 Wang Jun;Lin Weiming;Li Xiangyang(Department of Joint Surgery,Meizhou People’s Hospital,Meizhou 514031)

机构地区：[1]梅州市人民医院关节外科,广东梅州514031

出　　处：《中国现代医药杂志》2022年第9期23-27,共5页Modern Medicine Journal of China

基　　金：梅州市社会发展科技计划项目(编号:2019B013)。

摘　　要：目的探讨关节镜下自体腓骨长肌腱移植重建后交叉韧带(PCL)的临床效果及对踝关节的影响。方法回顾性选取我院关节外科收治的20例经临床确诊为PCL断裂,且均接受关节镜下自体腓骨长肌腱移植重建PCL手术的患者临床资料进行分析,根据手术移植腓骨长肌腱股数分为两股组(n=11)与三股组(n=9)。收集所有患者术前和术后末次随访时国际膝关节文献委员会(IKDC)评分、膝关节后向松弛度、Lysholm评分、疼痛视觉模拟(VAS)评分、美国矫形足踝协会(AOFAS)踝关节评分、膝关节屈伸活动度、后抽屉试验结果并进行组内及组间对比。结果20例患者术后末次随访的IKDC评分、Lysholm评分、膝关节屈伸活动度较术前均有明显上升(t=-25.486、-24.569、-16.314,均P<0.001),双膝后向松弛度差值、VAS评分较术前均明显下降(t=12.751、18.757,均P<0.001),AOFAS踝关节评分和术前比较差异无统计学意义(t=-0.816,P=0.741);术前后抽屉试验结果均为阳性,术后末次随访结果均为阴性。两股组与三股组患者术后末次随访IKDC评分、双膝后向松弛度差值、Lysholm评分、VAS评分、膝关节屈伸活动度均较术前均有明显改善(均P<0.05),AOFAS踝关节评分与术前比较差异无统计学意义(P>0.05),且组间上述指标对比差异均无统计学意义(均P>0.05)。结论关节镜下自体腓骨长肌腱移植重建PCL的临床效果较优,对踝关节功能无显著影响,临床上推荐用于治疗PCL断裂的患者。Objective To investigate the effect of arthroscopic autologous peroneus longus tendon graft to reconstruct posterior cruciate ligament and its influence on ankle joint. Methods The clinical data of 20 patients who were clinically diagnosed with PCL rupture and underwent arthroscopic autologous peroneus longus tendon graf to reconstruct PCL were retrospectively selected for analysis. According to the number of peroneus longus tendon grafts,they were divided into two-strand group(n=11) and three-strand group(n=9). The international knee documentation committee(IKDC) score, posterior knee laxity, lysholm score, visual analog scale(VAS) for pain, american orthopaedic foot and ankle society(AOFAS) ankle score, knee flexion and extension range of motion, and posterior drawer test were collected and compared within and between groups for all patients before operation and at the last followup after operation. Results The IKDC score, lysholm score, and knee flexion and extension range of motion at the last follow-up after operation in 20 patients were significantly increased compared with those before operation(t=-25.486,-24.569,-16.314, all P<0.001);the difference in posterior relaxation of both knees and the VAS score were significantly lower than those before operation(t=12.751, 18.757, all P<0.001);there was no significant difference in AOFAS ankle score between before operation and at the last follow-up after operation(t=-0.816, P=0.741);the results of the posterior drawer test before the operation were all positive, and the results of the last follow-up after the operation were all negative. IKDC score, difference in posterior relaxation of both knees, lysholm score, VAS score, and knee flexion and extension range of motion in the two-strand group and three-strand group at the lest follow-up after aperation were significantly improved compared with before operation(all P<0.05), there was no statistically significant difference in AOFAS ankle score compared with before operation(P>0.05);and there was no statistically

关 键 词：韧带重建 自体腓骨长肌腱移植 后交叉韧带 踝关节 关节镜 

分 类 号：R687.4[医药卫生—骨科学]