股骨止点两种不同定位方法对前交叉韧带重建术后近期疗效的影响

Effect of two methods of positioning femoral attachment of anterior cruciate ligament: a clinical comparative study

摘要:

目的  前瞻性对比前交叉韧带（ACL）股骨止点解剖重建和传统重建的术后近期临床疗效。方法  选取解放军第252医院2013年3月-2014年6月收治的ACL断裂患者62例予以关节镜下ACL重建手术治疗。其中，男50例，女12例；年龄19～51岁，平均（30.90±9.18）岁。根据拟行关节镜下ACL重建手术的股骨隧道定位点不同分为解剖重建组和对照组，术前随机抽取，采用解剖重建定位方式建立股骨隧道者32例，采取传统的单束重建定位方式建立股骨隧道的对照组30例。观察对比两组患者术后膝关节稳定性、活动度及Lysholm膝关节评分。结果  全部患者术后获6～15个月，平均（9.50±2.63）个月的随访，最后随访时，解剖重建组：全部患者膝关节屈伸活动度正常，Lysholm膝关节评分从术前的17～73分，平均（50.18±15.60）分提高至随访结束时的82～100分，平均（95.83±4.98）分，差异有统计学意义（P <0.05）。对照组：全部患者膝关节屈伸活动度正常，Lysholm膝关节评分从术前的15～74分，平均（49.93±18.16）分，提高至随访结束时的74～100分，平均（88.00±8.84）分，差异有统计学意义（P <0.05）。解剖重建组与对照组术前Lysholm评分差异无统计学意义（P >0.05），两组术后随访结束时的Lysholm评分前者优于后者且差异有统计学意义（P <0.05）。结论  关节镜下ACL股骨止点的解剖重建近期临床疗效优于传统的重建。

Abstract:

Objective To prospectively compare the postoperative clinical effect of anterior cruciate ligament (ACL) anatomical reconstruction with traditional reconstruction. Methods Sixty-two patients with the anterior cruciate rupture in our hospital were selected and randomly divided into two groups: anatomical reconstruction group and control group. Patients of the anatomical reconstruction group were given surgical treatment of arthroscopic anatomical reconstruction of single-bundle anterior cruciate ligament. Patients of both the anatomical and control groups were given surgical treatment of arthroscopic traditional reconstruction of single-bundle anterior cruciate ligament. The functions of knee were analyzed and compared 6-15 months after operation. Results Lysholm scores of all the patients significantly increased after operation. There was significant differences in these two scores between the two groups after operation, but no significant difference was found before operation. Conclusions Short-term curative effect of arthroscopic anatomical reconstruction ofACL is better than that of traditional reconstruction.