摘要
比较股骨牵张保残法与标准方法在术后膝关节本体感觉恢复方面的优劣。方法：回顾性分析2008年6月～2011年4月在我院收治的90例单侧前交叉韧带损伤患者．均行自体半腱肌及股薄肌腱韧带重建术。按所施术式将患者分为对照组（标准手术组）和试验组（保残重建组）两组。术前及术后进行Lysholm评分、IKDC评分、关节活动度测量、kneelax测量及本体感觉测量．结果：在患者性别、年龄、受伤原因及术前关节活动度、Lysholm评分、IKDC评分等方面，两组患者具有可比性，在对照组，有3名患者术后胫骨隧道切口延迟愈合．其他患者未发生术后并发症。据术后MRI检查．所有患者均无独眼畸形出现。术后2年随访时，两组问比较，试验组关节活动度为（123．5±7．5）o，对照组为（121．7±8．2）°（P=0．302）；试验组Lysholm评分为95．5±3．3。对照组为94．8±3．5（P=0．340）；试验组IKDC评分达到A或B的患者43例，对照组为44例（P=0．773）：试验组kneelax测量值为（0．6±1．0）mm，对照组为（0．6±0．9）mm（P=0．787）：试验组关节被动活动感知阈值度指数为（8．8±2．1）°，对照组为（10．6±0．3）°（P=0．002）。结论：自体半腱肌及股薄肌腱保残重建前交叉韧带在本体感觉恢复方面效果明显优于标准术式组。
Abstract Objective To evaluate the proprioception after ACL reconstruction by femoral tensioning with remnant preservation （FTRP）and semitendinosus and gracilis-tendon autograft （SCTA）. Methods 90 patients underwent unilateral ACL reconstruction respectively with FTRP and SGTA in our Department from June 2008 to April 2011. The Lysholm score,International Knee Documentation Committee （IKDC） grade,range of motion （ROM）,and proprioception measurement were carried out preoperatively and at the 2-year follow-up. Results The sex, age,cause of injury,preoperative ROM, Lysholm score and IKDC score were compared between the groups of FTRP and SGTA. Three patients in the group SGTA experienced delayed healing of the tibial tunnel,and the remaining patients had no immediate postoperative complications requiring reoperation or readmission. There was no cyclopia on MRI. The ROM of knee was 123.5±7.5° in the group FTRP and 121.7±8.2° in the group SGTA at the 2-yearfollow-up （P =0.302）. The 1,ysholm score was 95.5±3.3 ill tile group FTRP and 94.8±3.5 in the group S（;＇rA （P = 0.340）. ＇File IKI）C grade was A or B in 43 patients ira tile group FI＇RP trod 44 patients in tire group S（;TA （P = 0.773）. Tire Knee arthmmetry measurement was 0.6±1.0 mm in tire group FFRP and 0.6 ± 0.9 mm in the group SGTA （P = 0.787）. The threshold index of perception under passive movement of injured knee was 8.8±2.1°in the group FTRP and 10.6±3.3° in the group SGTA （P = O. 002）. Conclusion The remnant-preserving ACL reconstruction using autografts reveals tire advantalge in early recovery of proprioception over the regular technique.
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2014年第1期5-9,共5页
Chinese Journal of Sports Medicine
基金
国家自然科学基金(81272050)
关键词
前交叉韧带
关节镜
保残重建
本体感觉
膝关节
anterior cruciate ligament,reconstruction,arthroscopy,remnant preservation,propri -oception, knee
