膝关节镜手术时机对ACL伴半月板损伤患者稳定性应力、并发症、临床效果的影响  

Influence of Timing of Knee Arthroscopic Surgery on Stability Stress,Complications and Clinical Results in ACL with Meniscus Injury Patients

作　　者：徐新立 杨林 张勇 黄永青 XU Xinli;YANG Lin;ZHANG Yong;HUANG Yongqing(Department of Orthopaedics,General Hospital of Pingmei Shenma Group,Pingdingshan 467000,China)

机构地区：[1]平煤神马医疗集团总医院骨科,河南平顶山467000

出　　处：《河南医学研究》2025年第3期467-471,共5页Henan Medical Research

摘　　要：目的 探讨前交叉韧带(ACL)伴半月板损伤不同膝关节镜手术时机对稳定性应力、并发症、临床效果的影响。方法 回顾性分析2020年9月至2023年3月平煤神马医疗集团总医院骨科122例行膝关节镜ACL自体肌腱重建和半月板修整缝合术的ACL伴半月板损伤患者的临床资料,根据手术时机不同分为1~2周组(39例)、3~4周组(41例)、4~12周组(42例)。对比3组完全负重活动时间、膝关节功能[采用国际膝关节文献委员会膝关节评价表(IKDC)评分、膝关节Lysholm评估量表(Lysholm)评分评估]、患侧膝关节屈曲与伸直改变及并发症。结果 1~2周组、3~4周组患者完全负重活动时间早于4~12周组,且1~2周组患者完全负重活动时间早于3~4周组,差异有统计学意义(P<0.05);术后6个月1~2周组、3~4周组患者IKDC、Lysholm评分高于4~12周组,差异有统计学意义(P<0.05),但术后6个月1~2周组与3~4周组差异无统计学意义(P>0.05);术后6个月1~2周组、3~4周组患者患侧膝关节屈曲较健侧减少、患侧膝关节伸直较健侧减少程度低于4~12周组,差异有统计学意义(P<0.05),但术后6个月1~2周组与3~4周组差异无统计学意义(P>0.05);1~2周组、3~4周组患者并发症发生率低于4~12周组,差异有统计学意义(P<0.05)。结论 ACL伴半月板损伤1~2周、3~4周后进行膝关节镜手术疗效相近,可有效改善膝关节功能及屈伸度,减少术后并发症,但1~2周完全负重活动时间更短。Objective To investigate the effects of different timing of arthroscopic knee surgery on the stability stress,complications and clinical results of anterior cruciate ligament(ACL)with meniscus injury.Methods The clinical data of 122 patients with ACL with meniscus injury who underwent arthroscopic ACL autologous tendon reconstruction and meniscus trimming suture in Department of Orthopaedics,General Hospital of Pingmei Shenma Group from September 2020 to March 2023 were retrospectively analyzed,and were divided into 1 to 2 week group(39 cases),3 to 4 week group(41 cases),and 4 to 12 week group(42 cases)according to different operation timing.The time of full weight-bearing activity,knee function[assessed using the International Knee Documentation Committee knee evaluation scale(IKDC)score,and the Lysholm assessment scale for the knee(Lysholm)score],changes in flexion and extension of the affected knee,and complications were compared among the 3 groups.Results The time for patients in the 1-2 week group and 3-4 week group to fully bear weight was earlier than that in the 4-12 week group,and the time for patients in the 1-2 week group to fully bear weight was earlier than that in the 3-4 week group,with statistically significant differences(P<0.05).Six months after surgery,the IKDC and Lysholm scores of patients in the 1-2 week group and 3-4 week group were higher than those in the 4-12 week group,with statistically significant differences(P<0.05).However,there was no statistically significant difference between the 1-2 week group and 3-4 week group at six months after surgery(P>0.05).The degree of reduction in knee flexion and extension on the affected side compared to the healthy side was lower in the 1-2 week group and 3-4 week group than in the 4-12 week group,with statistically significant differences(P<0.05).However,there was no statistically significant difference between the 1-2 week group and 3-4 week group at six months after surgery(P>0.05).The incidence of complications in patients in the 1-2 week group

关 键 词：半月板损伤 前交叉韧带 关节镜 手术 并发症 膝关节 关节功能 

分 类 号：R684[医药卫生—骨科学]