摘要
目的探讨透视辅助前交叉韧带(ACL)重建术对ACL损伤患者膝关节功能及稳定性的影响。方法回顾性分析收治的175例ACL损伤患者的临床资料。根据不同手术方式分为对照组95例(常规关节镜下ACL重建术)和透视组80例(透视辅助关节镜下ACL重建术)。比较2组手术相关指标、膝关节功能恢复情况、骨髓道定位参数、膝关节稳定性和活动度以及并发症发生情况。结果透视组患者手术时间长于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术后12个月,透视组膝关节Lyshlom评分及国际膝关节文献委员会(IKDC)评分均高于对照组,差异有统计学意义(P<0.05)。透视组患者术后Blumensaat延长线与胫骨水平交点位置至胫骨隧道前边缘间距(a)与胫骨平台前后径宽度(c)比值(a/c)、Blumensaat线与胫骨隧道中轴线夹角(α角)小于对照组,Blumensaat线上垂直位点到Blumensaat线与股骨外侧髁前皮质交点间距(A)与Blumensaat线到股骨外侧髁前皮质交点间距(B)比值(A/B)大于对照组,差异有统计学意义(P<0.05)。术后12个月,透视组患者KT-2000和拉赫曼试验(Lachman)阳性率低于对照组,差异有统计学意义(P<0.05);透视组患者伸膝受限和屈曲受限角度均小于对照组,差异有统计学意义(P<0.05)。2组患者术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论透视辅助ACL重建术可有效改善ACL损伤患者术后膝关节功能和膝关节活动度,提升骨髓道定位准确性及膝关节稳定性,且安全可靠。
Objective To investigate the effects of fluoroscopy-assisted anterior cruciate ligament(ACL)reconstruction on knee function and stability in patients with ACL injury.Methods The clinical data of 175 patients with ACL injury were retrospectively analyzed.According to different surgical methods,the patients were divided into control group(n=95,conventional arthroscopic ACL reconstruction)and fluoroscopy group(n=80,fluoroscopy-assisted arthroscopic ACL reconstruction).The surgery-related indicators,knee function recovery,bone tunnel positioning parameters,knee stability and range of motion and occurrence of complications were compared between the two groups.Results The surgical time in the fluoroscopy group was significantly longer,and the amount of intraoperative blood loss was less than that in the control group(P<0.05).The knee Lyshlom score and International Knee Documentation Committee(IKDC)score at 12 months after surgery in the fluoroscopy group were significantly higher than those in the control group(P<0.05).The ratio of distance from intersection position of Blumensaat extension line and tibial level to the anterior edge of tibial tunnel(a)to the width of anteroposterior diameter of tibial plateau(c)(a/c),and angle between Blumensaat line and tibial tunnel axis line(αangle)in the fluoroscopy group were significantly smaller than those in the control group,while the ratio of distance from vertical site of Blumensaat line to intersection of Blumensaat line and anterior cortex of lateral femoral condyle(A)to distance from intersection of Blumensaat 1 lineand anterior cortex of lateral femoral condyle(B)(A/B)was significantly larger than that in the control group(P<0.05).At 12 months after surgery,the positive rates of KT-2000 test and Lachman test in the fluoroscopy group were significantly lower than those in the control group(P<0.05).The limited angles of knee extension and flexion after surgery in the fluoroscopy group were significantly smaller than those in the control group(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Fluoroscopy-assisted ACL reconstruction can effectively improve the postoperative knee function and knee range of motion in patients with ACL injury after surgery,improve the accuracy of bone marrow canal positioning and knee stability,and it is safe and reliable.
作者
徐忠建
蒋旭
张智鹏
潘玉飞
高明弈
XU Zhongjian;JIANG Xu;ZHANG Zhipeng;PAN Yufei;GAO Mingyi(Operating Room,Orthopedic Hospital of Sichuan Province,Chengdu,Sichuan,610041;Department of Knee Joint,Orthopedic Hospital of Sichuan Province,Chengdu,Sichuan,610041)
出处
《实用临床医药杂志》
CAS
2023年第6期24-28,共5页
Journal of Clinical Medicine in Practice
基金
2022年四川省干部保健科研项目(川干研2022-601)。
关键词
前交叉韧带损伤
前交叉韧带重建术
透视辅助
膝关节功能
稳定性
anterior cruciate ligament injury
anterior cruciate ligament reconstruction
fluoroscopy-assisted
knee function
stability
