摘要
目的探讨膝前交叉韧带(anterior cruciate ligament ACL)断裂后行自体腘绳肌腱解剖单束重建治疗术后病人膝关节三维步态变化的特点。方法2018年8月~2020年6月收治的单侧膝关节ACL断裂病人25例(损伤组),术中均经关节镜证实为ACL断裂并行自体腘绳肌腱解剖重建术。对照组25例,为健康对照组,利用三维运动捕捉系统记录正常膝关节的三维步态数据并与损伤组进行对比。对损伤组病人手术前后跟踪随访并进行Lysholm膝关节功能评分。结果对照组屈伸角度-2°~66°,内外翻转角度-5°~9°,内外旋转角度-4°~8°;ACL损伤后屈伸角度-5°~52°,内外翻转角度-3°~24°,内外旋转角度-13°~14°;ACL自体腘绳肌腱重建术后3个月时屈伸角度-2°~47°,内外翻转角度-5°~9°,内外旋转角度-6°~10°;ACL重建术后6个月时屈伸角度-2°~59°,内外翻转角度-4°~8°,内外旋转角度-5°~8°;ACL重建术后9个月时屈伸角度-2°~64°,内外翻转角度-2°~9°,内外旋转角度-2°~8°;ACL重建术后12个月时屈伸角度-2°~65°,内外翻转角度-1°~9°,内外旋转角度1°~8°。ACL断裂后膝关节由屈到伸、内外旋转、内外翻转角度变化范围均较对照组变大,差异有统计学意义(P<0.05);重建术后膝关节各活动方向的角度范围与术前比较明显改善,术后各个时间点与术前相比较,差异有统计学意义(P<0.05),重建术后9个月和12个月时的步态与术后3个月时比较明显改善,差异有统计学意义(P<0.05)。Lysholm评分由术前的(62.35±3.45)分增加到术后12个月的(93.62±3.51)分,差异有统计学意义(P<0.05)。结论ACL重建手术起到了稳定膝关节的作用,提高了Lysholm膝关节功能评分,随着时间推移,Lysholm膝关节功能评分逐渐提高,在术后9个月基本恢复正常。
Objective To investigate the characteristics of the three-dimensional gait changes of the knee joint after the single bundle anatomical reconstruction of autologous hamstring tendons after the rupture of the anterior cruciate ligament(ACL)of the knee.Methods From August 2018 to June 2020,twenty five patients with ACL rupture of the lateral knee joint were selected as the injury group.During the operation,ACL rupture was confirmed by arthroscopy and the autologous hamstring tendon anatomical reconstruction was performed.Then 25 healthy people were selected as the control group.The three-dimensional gait data of normal knee joints were recorded with the three-dimensional motion capture system and compared with the injury group.In addition,the injury group was followed up before and after surgery and Lysholm knee joint function score was performed.Results In the control group,the flexion and extension angle was-2°~66°,the internal and external rotation angle was-5°~9°,and the internal and external rotation angle was-4°~8°.After ACL injury,the flexion and extension angle is-5°~52°,the internal and external rotation angle is-3°~24°,and the internal and external rotation angle is-13°~14°.Three months after ACL autologous hamstring tendon reconstruction,the flexion and extension angle was-2°~47°,the internal and external rotation angle was-5°~9°,and the internal and external rotation angle was-6°~10°.Six months after ACL reconstruction,the flexion and extension angle was-2°~59°,the internal and external rotation angle was-4°~8°,and the internal and external rotation angle was-5°~8°.Nine months after ACL reconstruction,the flexion and extension angle was-2°~64°,the internal and external rotation angle was-2°~9°,and the internal and external rotation angle was-2°~8°.12 months after ACL reconstruction,the flexion and extension angle was-2°~65°,the internal and external rotation angle was-1°~9°,and the internal and external rotation angle was-1°~8°.After ACL rupture,the variation range of
作者
刘诚
赵领财
王浩
白笋蓬
LIU Cheng;ZHAO Lingcai;WANG Hao(Department of Orthopedics,the First People’s Hospital of Tianmen City,Hubei,Tianmen 431700,China)
出处
《临床外科杂志》
2023年第4期321-325,共5页
Journal of Clinical Surgery
关键词
前交叉韧带损伤
韧带重建
三维步态分析
anterior cruciate ligament injury
ligament reconstruction
three-dimensional gait analysis
