不同时机膝关节镜下前交叉韧带重建术治疗前交叉韧带损伤的效果比较  

Comparison of the effect of arthroscopic anterior cruciate ligament reconstruction on anterior cruciate ligament injury at different times

作　　者：马伟涛[1] 李顺国[1] 张富运[1] 肖飞 方加尧 Ma Weitao;Li Shunguo;Zhang Fuyun;Xiao Fei;Fang Jiayao(Department of Orthopedics,Jiaozuo Second People's Hospital,Jiaozuo 454001,China)

机构地区：[1]河南省焦作市第二人民医院骨科,454001

出　　处：《临床医学》2025年第2期19-22,共4页Clinical Medicine

摘　　要：目的 比较不同时机膝关节镜下前交叉韧带(ACL)重建术治疗ACL损伤的效果。方法 选择2020年1月至2023年12月焦作市第二人民医院收治的74例ACL损伤患者为研究对象,根据手术时机分为早期组与晚期组,每组37例。全部患者均接受膝关节镜下ACL重建治疗,早期组于受伤3周内实施手术治疗,晚期组于受伤3周后实施手术治疗。比较两组围术期指标(术中操作时间、出血量、住院天数)、疼痛程度[视觉模拟评分法(VAS)评分]、膝关节功能[美国特种外科医院膝关节量表(HSS)评分]、膝关节恢复情况(膝关节活动度、伸膝受限度、屈膝受限度)及并发症。结果 早期组住院天数短于晚期组,差异有统计学意义(P<0.05);两组术中操作时间、出血量比较,差异未见统计学意义(P>0.05)。术后6个月,早期组VAS评分低于晚期组,HSS评分高于晚期组,膝关节活动度高于晚期组,伸膝受限度、屈膝受限度低于晚期组,差异有统计学意义(P<0.05)。早期组并发症发生率为5.41%(2/37),晚期组为21.62%(8/37),差异有统计学意义(P<0.05)。结论 早期膝关节镜下ACL重建术在ACL损伤的患者中能缩短住院天数,减轻疼痛感,加快膝关节功能恢复速度,且早期手术还能提高膝关节活动度,降低伸膝受限度、屈膝受限度及并发症发生率。Objective To compare the effect of arthroscopic anterior cruciate ligament(ACL)reconstruction on ACL injury at different times.Methods A total of 74 patients with ACL injury in the Second People's Hospital of Jiaozuo from January 2020 to December 2023 were selected as the study objects.The patients were divided into early group and late group according to different timing of operation,with 37 cases in each group.All patients received arthroscopic ACL reconstruction.The early group received surgery within 3 weeks after injury,and the late group received surgery 3 weeks after injury.The perioperative indexes(intraoperative operation time,bleeding volume,hospital stay),pain degree[visual analogue scale(VAS)],knee function[American Hospital for Special Surgery Knee Scale(HSS)],knee recovery status(knee joint range of motion,knee extension limit,knee flexion limit)and complication rates were compared between the two groups.Results The days of hospital stay in the early group were shorter than that of the late group,the diference was significant(P<0.05).There was no significant dfference in the operation time,bleeding time between the two groups(P>0.05).At 6 months after surgery,the VAS score of the early group was lower than that of the late group,the HSS score was higher than that of the late group,the knee motion of the early group was higher than that of the late group,and the knee extension and knee bending were less restricted than those of the late group,the differences were significant(P<0.05).The complication rate of the early group was 5.41%(2/37),which was lower than that of the late group(21.62%,8/37,P<0.05).Conclusions Compared with late surgery,early arthroscopic ACL reconstruction in patients with ACL injury can shorten the length of hospital stay,reduce pain,and speed up the recovery of knee function.In addition,early surgery can also improve knee mobility,reduce the limitation of knee extension and knee kneeling,and reduce the incidence of complications.

关 键 词：前交叉韧带损伤 不同时机 膝关节镜下前交叉韧带重建术 

分 类 号：R687.4[医药卫生—骨科学]