踝关节镜下缝线锚钉和无结锚钉修补前距腓韧带的临床疗效分析  

Analysis of the clinical efficacy of repairing the anterior talofibular ligament under ankle arthroscopy with suture anchors and knotless anchors

作　　者：梁文卫 郭敦明[1] 宋黄鹤[1] LIANG Wen-wei;GUO Dun-ming;SONG Huang-he(Department of Orthopedics,First Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院骨科,江苏南京210029

出　　处：《局解手术学杂志》2024年第11期1004-1008,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金(81601897)。

摘　　要：目的探讨缝线锚钉和无结锚钉修补前距腓韧带的临床效果。方法纳入2018年1月至2021年12月南京医科大学第一附属医院收治的187例距腓前韧带损伤引起踝关节慢性不稳患者,根据治疗方式不同将其分为缝线锚钉组(97例)和无结锚钉组(90例)。缝线锚钉组患者采用缝线锚钉修补,无结锚钉组患者采用无结锚钉修补。术后随访24~48个月,分别比较2组患者术前及术后美国足踝外科协会(AOFAS)评分、视觉模拟评分法(VAS)评分、坎伯兰踝关节不稳量表(CAIT)评分,术后12个月行踝关节MR评估患者恢复情况。观察患者术后并发症发生情况。结果术前、末次随访,2组患者VAS评分、AOFAS评分、CAIT评分比较,差异均无统计学意义(P>0.05);末次随访时,2组患者VAS评分明显低于术前,AOFAS评分、CAIT评分明显高于术前,差异均有统计学意义(P<0.05)。缝线锚钉组患者未发现缝线松动或线结激惹周围软组织,无结锚钉组患者也未发现无结锚钉松动的迹象。所有患者术后均未发生感染、血栓等并发症。缝线锚钉组有3例患者、无结锚钉组有2例患者术后早期存在足背部局部皮肤麻木,均于随访6个月时消失。随访12个月,缝线锚钉组有1例患者术侧皮下有不适感,可疑线结反应,但MR复查未发现明显异常。结论采用缝线锚钉或无结锚钉对踝关节慢性不稳的患者进行前距腓韧带修补临床效果相近,患者术后踝关节稳定性均得到明显提高。Objective To investigate the clinical outcomes of suture anchors and knotless anchors in the repair of anterior talofibular ligament.Methods A total of 187 patients with chronic ankle instability caused by anterior talofibular ligament injury admitted to First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2021 were included and divided into the suture anchor group(97 cases)and the knotless anchor group(90 cases)according to the treatment methods.Patients in the suture anchor group were repaired with suture anchor,and patients in the knotless anchor group were repaired with knotless anchor.The postoperative follow-up was conducted for 24 to 48 months,the American Foot and Ankle Association(AOFAS)scores,visual analogue scale(VAS)scores and Cumberland ankle instability tool(CAIT)scores before and after surgery were compared between the two groups,and the ankle MR was performed 12 months after surgery to evaluate the recovery of patients.The complications of patients after surgery were observed.Results There was no significant difference in the VAS score,AOFAS scores or CAIT scores before surgery and at the end of follow-up between the two groups(P>0.05).At the end of follow-up,the VAS scores of the two groups were significantly lower than those before surgery,and the AOFAS scores and CAITs score were significantly higher than those before surgery,with significant differences(P<0.05).The sutures loosing or knots that irritated the surrounding soft tissues was not found in the patients of the suture anchor group,and the signs of knotless anchor loosening was not found in the patients of the knotless suture group.Postoperative complications such as infection and thrombosis were not found in all patients.The local skin numbness at the back of the foot in the early postoperative period was found in 3 patients of the suture anchor group and 2 patients of the knotless suture group,which disappeared at 6 months of follow-up.One patient in the suture anchor group reported subcutaneous discom

关 键 词：缝线锚钉 无结锚钉 前距腓韧带 踝关节不稳 

分 类 号：R687.3[医药卫生—骨科学]