全镜下踝关节外侧副韧带修补术后距骨倾斜角改变与关节稳定性的关系  

The Relationship between the Change of Talar Tilt Angle and Joint Stability after All-Inside Arthroscopic Lateral Collateral Ligament Repair

作　　者：臧永辉 杨衡[1] 弋卓君 谢明锐 许瀚 ZANG Yonghui;YANG Heng;YI Zhuojun;XIE Mingrui;XU Han(Mianyang Central Hospital,Mianyang 621000,Sichuan China)

机构地区：[1]绵阳市中心医院,四川绵阳621000

出　　处：《中国中医骨伤科杂志》2025年第2期61-66,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨全镜下踝关节外侧副韧带修补术后距骨倾斜角改变与关节稳定性的关系。方法:选择2020年10月至2022年10月收治的接受全镜下踝关节外侧副韧带修补术治疗的慢性踝关节不稳定(CAI)患者80例,根据术后距骨倾斜角的改善情况将患者分为优良组(52例)和不良组(28例),分析比较两组临床资料,术前及术后1,2,3个月距骨倾斜角改变和关节稳定性并分析二者的关系。结果:与术前比,术后2个月及术后3个月优良组距骨倾斜角显著降低,差异有统计学意义(P<0.05);与不良组比,优良组术后3个月距骨倾斜角显著降低,差异有统计学意义(P<0.05)。与不良组比,优良组踝关节相对峰力矩(RPT)、主动位置觉、下肢Y-平衡(YBT-LQ)显著增大,差异有统计学意义(P<0.05),动态控制率(DCR)、被动位置觉显著减小,差异有统计学意义(P<0.05)。动态控制率、被动位置觉是术后距骨倾斜角改善不良的危险因素,而踝关节相对峰力矩、下肢Y-平衡是其保护因素。结论:全镜下踝关节外侧副韧带修补术后,距骨倾斜角改善与关节稳定性密切相关,临床应关注踝关节多项生物力学指标,制定个性化康复计划,以优化全镜下修补术对慢性踝关节不稳定的治疗效果,降低术后恢复不良风险。Objective:To investigate the relationship between the change of talar tilt angle and joint stability after all-inside arthroscopic lateral collateral ligament repair.Methods:From October 2020 to October 2022,80 patients with chronic ankle instability(CAI)who underwent all-in arthroscopic lateral collateral ligament repair were selected.According to the improvement of talar tilt angle after surgery,the patients were divided into excellent group(52 cases)and poor group(28 cases),and the clinical data were compared between the two groups.The changes of talar tilt angle and joint stability before operation and 1,2,and 3 months after operation were analyzed.Results:Compared with pre-operation,the talus tilt angle in excellent group was significantly decreased at 2 months and 3 months after operation(P<0.05).Compared with the poor group,the talar tilt angle in the excellent group was significantly decreased at 3 months after operation(P<0.05).Compared with the poor group,relative peak moment of the ankle joint(RPT),active position perception,and lower limb Y-balance(YBT-LQ)in the excellent group were significantly increased(P<0.05),and dynamic control rate(DCR)and passive position perception were significantly decreased(P<0.05).DCR and passive position sense are risk factors for poor postoperative improvement of talar tilt angle,while RPT and YBT-LQ are protective factors.Conclusion:The improvement of talar tilt angle after all-inside arthroscopic lateral collateral ligament repair is closely related to joint stability.Clinical attention should be paid to a number of biomechanical indicators of the ankle joint,and a personalized rehabilitation plan should be developed to optimize the treatment effect of all-inside arthroscopic repair on CAI and reduce the risk of poor postoperative recovery.

关 键 词：踝关节外侧副韧带 踝关节镜手术 距骨倾斜角 关节稳定性 

分 类 号：R686.5[医药卫生—骨科学]