关节镜下三入路联合椭圆隧道技术在前交叉韧带重建术中的应用  

Application of arthroscopic three-approach combined with elliptical tunnel technique in anterior cruciate ligament reconstruction

作　　者：马寅华 陈肖燕 汤红伟 MA Yin-hua;CHEN Xiao-yan;TANG Hong-wei(Department of Orthopedics,Jiading Central Hospital,Shanghai University of Medicine and Health Sciences,Shanghai 201800,China;Day Ward,Jiading Central Hospital,Shanghai University of Medicine and Health Sciences,Shanghai 201800,China)

机构地区：[1]上海健康医学院附属嘉定区中心医院骨科,上海201800 [2]上海健康医学院附属嘉定区中心医院日间病房,上海201800

出　　处：《局解手术学杂志》2024年第11期999-1003,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：嘉定区自然科学研究课题(JDKW-2021-0021)。

摘　　要：目的探讨关节镜下三入路联合椭圆隧道技术在前交叉韧带(ACL)重建术中的应用价值。方法选取我院收治的ACL损伤患者104例开展前瞻性分析,按照随机数字表法分为观察组和对照组,每组52例。2组患者均行ACL重建术治疗,观察组患者采取关节镜下三入路联合椭圆隧道技术,对照组患者采取传统前内侧入路联合椭圆隧道技术。比较2组患者手术相关指标、术后骨隧道定位参数、术后移植物成熟情况、膝关节稳定性(Lachman试验)、膝关节功能Lysholm评分及并发症发生情况。结果观察组患者扶拐下床活动时间、弃拐行走时间、恢复运动时间短于对照组(P<0.05);观察组患者术后A/B大于对照组,a/c、α小于对照组(P<0.05);观察组患者术后6个月、12个月近端、中段、远端移植物信号/噪声比(SNQ)均低于对照组(P<0.05);术后6个月,观察组患者膝关节稳定性优于对照组,膝关节功能Lysholm评分高于对照组(P<0.05);2组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论关节镜下三入路联合椭圆隧道技术用于ACL重建术中能改善骨隧道形态,促进移植物成熟,缩短术后恢复进程,改善膝关节功能,具有较高的安全性。Objective To investigate the application value of arthroscopic three-approach combined with elliptical tunnel technique in anterior cruciate ligament(ACL)reconstruction.Methods A prospective analysis was conducted on 104 patients with ACL injury admitted to our hospital.They were randomly divided into the observation group and the control group according to a random number table method,with 52 cases in each group.All patients in both groups underwent ACL reconstruction.The patients in the observation group were treated with the arthroscopic three-approach combined with elliptical tunnel technique,while the patients in the control group were treated with the traditional anteromedial approach and elliptical tunnel technique.The surgical related indicators,parameters of postoperative bone tunnel positioning,postoperative graft maturation,knee stability(Lachman test),Lysholm score of knee function,and complications of patients were compared between the two groups.Results The time of getting out of bed with crutches,time of walking without crutches and recovery time of patients in the observation group were shorter than those in the control group(P<0.05).The A/B value of patients in the observation group was greater than that in the control group,and the a/c andαwere smaller than those in the control group(P<0.05).The signal/noise quotient(SNQ)of the proximal,middle,and distal grafts 6 and 12 months after surgery of patients in the observation group were lower than those in the control group(P<0.05).At 6 months postoperatively,the knee stability of patients in the observation group was better than that in the control group,and the Lysholm score of knee function was higher than that in the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Arthroscopic three-approach combined with elliptical tunnel technique can improve the morphology of bone tunnel,promote graft maturation,shorten postoperative recovery process,and improv

关 键 词：前交叉韧带重建术 椭圆隧道技术 关节镜 三入路 关节稳定性 膝关节功能 移植物 

分 类 号：R687.4[医药卫生—骨科学]