摘要
[目的]比较两种锚钉技术关节镜下距腓前韧带(anterior talofibular ligament,ATFL)修复中的临床效果。[方法]回顾性分析2018年1月—2021年1月本院关节镜下锚钉修复ATFL的88例患者的临床资料。根据术前医患沟通结果,49例患者采用无结锚钉修复技术(无结组),另外39例患者采打结锚钉修复技术(打结组)。比较两组围手术期、随访及影像资料。[结果]两组手术时间、失血量、切口长度、下地行走时间及住院时间的差异均无统计学意义(P>0.05),但是,无结组出现异物反应的比率显著低于打结组(0%vs 33.3%,P<0.001)。所有患者均获得24个月以上的随访,两组患者恢复完全负重时间的差异无统计学意义(P>0.05)。与术前相比,末次随访两组踝背伸-跖屈ROM、Karlsson-Peterson评分、AOFAS评分较术前均显著增加(P<0.05),而踝内翻-外翻ROM和VAS评分显著减少(P<0.05),前抽屉试验显著改善(P<0.05)。相应时间点,两组间上述指标的差异均无统计学意义(P>0.05)。影像方面,与术前相比,末次随访时两组的距骨内翻应力位距骨倾斜角(talar tilt,TT)和前抽屉应力距骨前移位(anterior displacement,AD)值均显著减少(P<0.05)。相应时间点,两组间TT及AD值的差异均无统计学意义(P>0.05)。[结论]两种锚钉关节镜下ATFL修复技术治疗慢性踝关节外侧韧带损伤,均能够恢复稳定性,取得良好的临床效果。相比之下,无结锚钉的早期异物反应更小。
[Objective]To compare the clinical outcomes of two anchor techniques in arthroscopic repair of the anterior talofibular ligament(ATFL)for chronic lateral ankle instability(CLAI).[Methods]A retrospective study was performed on 88 patients who underwent arthroscopic repair of ATFL with anchors for CIAI in our hospital from January 2018 to January 2021.According to the doctor-patient communication preoperatively,49 patients received repair with the knotless anchor,while the other 39 patients were with the knotted anchor.The perioperative,follow-up and imaging data of the two groups were compared.[Results]Although there were no significant differences in operation time,intraoperative blood loss,incision length,walking time and hospital stay between the two groups(P>0.05),the knotless group got significantly lower incidence of foreign body reaction than the knoted group(0%vs 33.3%,P<0.001).All patients were followed for more than 24 months,and there was no statistically significant difference in the time to regain full weight bearing between the two groups(P>0.05).Compared with those preoperatively,the ankle dorsal extension-plantar flexion range of motion(ROM),Karlson-Peterson score and AOFAS score significantly increased(P<0.05),while the varus-valgus ROM and VAS scores significantly reduced(P<0.05),and the anterior drawer test significantly improved in both groups at the latest follow-up(P<0.05).However,there were no statistically significant differences in the above indexes between the two groups at any time points accordingly(P>0.05).Regarding imaging,the talar tilt(TT)under inversion stress and anterior displacement(AD)under anterior drawer stress significantly reduced in both groups at the last followup compared with those preoperatively(P<0.05),whereas which were not statistically significant between the two groups at any time points accordingly(P>0.05).[Conclusion]Both kinds of anchor used in arthroscopic repair of ATFL for the CLAI do restore stability and achieve good clinical consequences.In contrast,the k
作者
周鹏
赵茂胜
杨小杰
李慎松
张鹏
ZHOU Peng;ZHAO Mao-sheng;YANG Xiao-jie;LI Shen-song;ZHANG Peng(Department of Sports Medicine,The 940th Hospital,Joint Logistic Support Force of PLA,Lanzhou 730050,China;Department of Orthopaedics,The 941stHospital,Joint Logistic Support Force of PLA,Xining 810000,China;Department of Sports Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2024年第2期109-114,共6页
Orthopedic Journal of China
基金
部队专项培育项目(编号:2021yxky012)。
