摘要
目的:对自体、异体骨-髌腱-骨重建前交叉韧带术后介入功能训练改善膝关节功能情况进行评价。方法:病例来源于1998-11/2002-12在中山大学附属第二医院就诊的因前交叉韧带断裂而接受关节镜下骨-髌腱-骨重建前交叉韧带手术的患者18例,其中9例采用自体骨-髌腱-骨重建前交叉韧带(自体组),9例采用同种异体骨-髌腱-骨重建前交叉韧带(异体组)。两组患者术后进行系统性功能康复锻炼:①术后第1天起进行绳肌、股四头肌等长收缩练习。自体取材者2周后,异体取材者3周后进行直腿抬高、绳肌抗阻收缩训练。②被动和主动活动度训练,以患者能忍受为限:1周内完全伸直,自体取材者1周后练习屈膝,3周内达90o～100o。异体取材者1～3周后练习屈膝,4周内达90o。③负重行走:自体取材者1周内借助拐杖和支具帮助部分负重,逐渐完全负重,异体取材者2周后借助拐杖和支具帮助部分负重。④支具保护:自体取材者3～6个月,异体取材者6～10个月。⑤有氧运动:自体取材者3周后恢复低冲撞的有氧训练,6个月后开始恢复于术前水平相当的运动。异体取材者6周后恢复低冲撞的有氧训练,9～12个月后开始恢复于术前水平相当的运动。并根据患者的实际情况调整锻炼方案和时间。采用门诊随访和上门随访的方法,在术后3个月内每月随访1次,术后3～12个月每3个月随访1次,术后1年以上每6个月随访1次。观察手术前后膝关节稳定性,以前抽屉试验和Lachman轴移试验为量化指标(Lysholm评分,100分为正常,80分以上为优,79～70分为良,69～60分为中,60分以下为差),膝关节功能以膝关节活动度评价,比较主观满意度(满意3分、比较满意2分、可以接受1分、不满0分)。结果:两组患者在治疗中无脱失,在随访中无失访,各有9例患者纳入结果分析。随访27～77个月,平均41个月。①膝关节稳定性:18例患者术后均有明�
AIM： To evaluate the amelioration condition of knee joint function intervened with functional training after the reconstruction of the anterior cruciate ligament operation by Bone-Patellar Tendon-Bone autograft or allograft.METHODS： Eighteen patients with anterior cruciate ligament disruption who underwent anterior crucaite ligament reconstruction by Bone-Patellar Tendon Bone under arthroscope in the Second Affiliated Hospital of Sun Yat-sen University were sdected from November 1998 to December 2002.Among those, nine were reconstructed with Bone-Patellar Tendon-Bone autograft on anterior cruciate ligament （autograft group）. Nine were treated with Bone-Patellar Tendon-Bone allograft anterior cruciate ligament （allograft group）. Patients in the two groups were performed the system functional rehabilitation exercise after operation： ① The isometric contraction training of hamstring muscles and quadrieeps femoris were conducted from the first day after operation. The elevation of straight leg and anti-prevention contraction training were performed 2 weeks after the patients who draw the materials autologously and 3 weeks after the patients who draw the materials xenomaly. ② The training of range of passive and active movement, the limit was that the patients could endure： completely straighten within 1 week, the patients who draw the materials autologously after 1 week exercised flexion of knee, and reached 90°-100° within 3 weeks, The patients who draw the materials xenomaly after 1-3 weeks exercised flexion of knee, and reached 90~ within 4 weeks, ③ Walking with weight loading： The patients who draw the materials autologously drew assistance from crutch and brace to help part of weight loading within 1 week, and gradually completely weight loading. The patients who draw the materials xenomaly drew assistance from crutch and brace to help part of weight loading after 2 weeks, ④ Brace protection： the patients who draw the materials autologously for 3-6 months, the patients who draw the
出处
《中国临床康复》
CSCD
北大核心
2005年第26期1-3,共3页
Chinese Journal of Clinical Rehabilitation
