摘要
目的 分析两种修复方式治疗伴内侧副韧带(MCL)断裂的前交叉韧带(ACL)损伤的效果.方法 以电脑随机数字表法将2021 年4 月至2022 年11 月收治的88 例伴MCL断裂的ACL损伤患者分为观察组和对照组,每组44 例.对照组采用腘绳肌腱与MCL止点重建,观察组采用腓骨长肌腱与MCL止点重建.比较 2 组手术状况、康复进程、并发症状况、膝关节功能[国际膝关节文献委员会膝关节评估表(IKDC)、Tegner评分、Lysholm评分]、膝关节稳定性、移植物磁共振成像(MRI)表现、踝关节功能[美国矫形足踝协会(AOFAS)踝-脚足评分]、足功能、步态以及并发症情况.结果 观察组肌腱直径大于对照组,肌腱长度长于对照组(P＜0.01).术后6 个月,观察组Lysholm评分、IKDC评分、Tegner评分高于对照组(P＜0.05).术后6、12 个月,2 组Lachman试验、轴移试验、应力位内侧间隙开大程度、AOFAS踝-脚足评分比较无明显差异(P＞0.05).术后12 个月,2 组移植物MRI表现、足功能、步态及并发症发生率比较无明显差异(P＞0.05).结论 腓骨长肌腱、腘绳肌腱分别联合MCL止点重建治疗伴MCL断裂的ACL损伤患者在改善并发症、足踝功能等方面效果相似,但前者可改善肌腱重构,促进膝关节功能恢复.
Abstract
Objective To analyze the effect of two repair methods on anterior cruciate ligament(ACL)injury with medial collateral ligament(MCL)rupture.Methods A total of 88 patients with ACL injury and MCL rupture admitted from April 2021 to November 2022 were divided into observation group(n=44)and control group(n=44)by random number ta-ble method.The control group underwent reconstruction using hamstring tendon and attachment of MCL,and the observation group underwent reconstruction using peroneal long tendon and attachment of MCL.The surgical status,recovery process,complications,knee function[International Knee Documentation Committee Knee Form(IKDC),Tegner score,Lysholm score],knee stability,graft magnetic resonance imaging(MRI),ankle function[American Orthopaedic Foot and Ankle Soci-ety(AOFAS)ankle-foot score],foot function,gait,and complications were compared between the two groups.Results The tendon diameter was larger and tendon length was greater in the observation group than in the control group(P＜0.01).At 6 months after operation,Lysholm score,IKDC score and Tegner score in observation group were higher than those in control group(P＜0.05).At 6 and 12 months after operation,there were no significant differences between the two groups in Lach-man test,axial shift test,medial space opening degree of stress position and AOFAS ankle-foot score(P＞0.05).At 12 months after operation,there were no significant differences in MRI findings,foot function,gait and complication rate between the two groups(P＞0.05).Conclusion Peroneal longus tendon and hamstring tendon combined with MCL attachment re-construction have similar effects on improving complications and ankle function in ACL patients with MCL rupture,but the for-mer can improve tendon reconstruction and promote recovery of knee function.
基金项目
河北省2019年度医学科学研究课题计划(20191584)
维普
万方数据