关节镜下锚钉保残与常规前交叉韧带重建比较
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1.山东中医药大学;2.山东中医药大学附属医院

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Comparison of arthroscopic anchor nailing for stump preservation and conventional anterior cruciate ligament reconstruction
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1.Shandong Traditional Chinese Medicine University;2.The Affiliated Hospital of Shandong University of Traditional Chinese Medicine

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    摘要:

    [目的]对比分析常规前交叉韧带重建与联合锚钉保残的中短期临床疗效。[方法]回顾性分析2019年3月-2021年3月共51例前交叉韧带重建的患者,均采用自体腘绳肌腱重建前交叉韧带。常规组26例,仅重建韧带;保残组25例,在重建韧带的基础上,应用带线锚钉将股骨端撕裂的前交叉韧带残端紧缩固定于股骨骨道周围。比较两组围手术期情况及手术前后功能评分。[结果]51例患者全部成功接受手术,未出现血管、神经损伤。保残组手术时间较长,但下地行走时间早,差异有统计学意义(P<0.01);两组术后均恢复膝关节稳定性,差异无统计学意义(P>0.05);功能评分上,三个月随访,保残组Lysholm、IKDC2000评分更高,差异有统计学意义(P<0.05);膝关节被动角度再生试验中,术后3个月两组差异具有统计学意义(P<0.01);骨髓道扩大情况中,术后3个月时保残组少于常规组,差异有统计学意义(P<0.05);K-L关节退变评级中,两组差异无统计学意义(P>0.05)。[结论]常规重建与联合锚钉保残均可恢复关节稳定性,在短期内锚钉保残术膝功能及本体感觉恢复更好,但中长期来看两种术式效果无明显差别。

    Abstract:

    [Objective]To compare and analyze the short- and medium-term clinical efficacy of conventional anterior cruciate ligament reconstruction and arthroscopic anchor nailing for stump preservation.[Methods]A total of 51 patients with anterior cruciate ligament reconstruction from March 2019 to March 2021 were retrospectively analyzed, all of whom had their anterior cruciate ligaments reconstructed with autologous hamstring tendons. In the conventional group of 26 cases, only the ligament was reconstructed; in the residual preservation group of 25 cases, on the basis of the reconstructed ligament, the torn anterior cruciate ligament stump at the femoral end was fixed tightly around the femoral tract by applying a wire anchor nail. The perioperative conditions and functional scores before and after surgery were compared between the two groups.[Results]All 51 patients underwent successful surgery without vascular or nerve injury. The surgery time was longer in the disability-preserving group, but the time to walk on the ground was earlier, and the difference was statistically significant (P < 0.01); both groups recovered knee stability after surgery, and the difference was not statistically significant (P > 0.05); on the functional score, the Lysholm and IKDC2000 scores were higher in the disability-preserving group at the three-month follow-up, and the difference was statistically significant (P < 0.05); knee passive angle regeneration test, the difference between the two groups at 3 months postoperatively was statistically significant (P < 0.01); in the case of bone marrow tract enlargement, the disability-preserving group was less than the conventional group at 3 months postoperatively, and the difference was statistically significant (P < 0.05); in the K-L joint degeneration rating, the difference between the two groups was not statistically significant (P > 0.05).[Conclusion]Both conventional reconstruction and combined anchor nailing for disability preservation can restore joint stability, and in the short term anchor nailing for disability preservation restores knee function and proprioception better, but there is no significant difference between the two procedures in the medium and long term.

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  • 收稿日期:2022-04-27
  • 最后修改日期:2022-08-04
  • 录用日期:2022-11-07
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