目的 对比关节镜下距腓前韧带线带增强修复与距腓前韧带重建治疗慢性外侧踝关节不稳的临床疗效。方法 回顾分析2022年1月至2024年2月上海中医大学深圳医院收治的行关节镜下线带增强修复距腓前韧带(线带组)与关节镜下单纯距腓前韧带重建(重建组)的48例患者资料。线带组26例，男20例，女6例;年龄18～53岁，平均(36。57±10。57)岁;受伤至手术时间(25。46±28。09)个月。重建组22例，男18例，女4例;年龄19～45岁，平均(34。45±09。63)岁;受伤至手术时间(28。45±26。26)个月。比较两组手术时长、术中C型臂透视次数、住院天数及手术前后美国足踝外科协会(American orthopaedics foot and ankle society，AOFAS)踝-后足功能评分、足踝功能测量(foot and ankle abilitly measure，FAAM)评分、疼痛视觉模拟评分(visual analogue scale，VAS)，术后 6 个月应用改良Macnab评分评价两组优良率。结果 两组患者均获6个月随访。与重建组比较，线带组手术时长更短(P＜0。001)，术中C型臂透视次数更少(P＜0。001)。两组术后住院时长、术后6个月VAS、AOFAS、FAAM评分差异无统计学意义(P＞0。05)。依照改良MacNab标准，观察组优21例，良4例，可1例，优良率为96。15％;对照组优17例，良4例，可1例，优良率95。45％，两组优良率比较差异无统计学意义(P＞0。05)。结论 关节镜下距腓前韧带线带修复技术治疗慢性外侧踝关节不稳安全、有效，较距腓前韧带重建术，具有手术时间短、放射暴露少、恢复时间快的优点。
A Comparative Study of Arthroscopic Tape Augmentation Versus Ligament Reconstruction for the Treatment of Lateral Ankle Instability
Objective To explore the clinical efficacy of arthroscopic tape augmentation repair of the anterior talofibular ligament(ATFL)compared to ATFL reconstruction in the treatment of chronic lateral ankle instability.Methods A retrospective review was conducted on 48 patients who underwent arthroscopic tape augmentation repair of the ATFL(augmentation group)and arthroscopic simple ATFL reconstruction(reconstruction group)at Shanghai University of Traditional Chinese Medicine Shenzhen Hospital from January 2022 to February 2024.The augmentation group included 26 cases,with 20 males and 6 females;ages ranged from 18 to 53 years,with an average of(36.57±10.57)years;the duration of injury was(25.46±28.09)months.The reconstruction group included 22 cases,with 18 males and 4 females;ages ranged from 19 to 45 years,with an average of(34.45±9.63)years;the duration of injury was(28.45±26.26)months.The duration of surgery,the number of intraoperative C-arm fluoroscopies,and the length of hospital stay were compared between the two groups.Preoperative and postoperative scores at 6 months were assessed using the American orthopedic foot and ankle society(AOFAS)hindfoot function score,foot and ankle ability measure(FAAM)score,and visual analogue scale(VAS)score.The modified Macnab criteria were applied at the 6-month follow-up to evaluate the rate of excellent and good outcomes in both groups.Results Both groups of patients were followed up for 6 months.Compared to the reconstruction group,the augmentation group had a shorter surgical duration(P＜0.001)and fewer intraoperative C-arm fluoroscopies(P＜0.001).There were no statistically significant differences in postoperative hospital stay,VAS,AOFAS,and FAAM scores at the last follow-up after 6 months between the two groups(P＞0.05).According to the modified Macnab criteria,the augmentation group had 21 excellent cases,4 good cases,and 1 fair case,resulting in an excellent-good rate of 96.15％.The reconstruction group had 17 excellent cases,4 good cases,and 1 fair case,resulting in an excellent-good rate of 95.45％.There was no statistically significant difference between the two groups(P＞0.05).Conclusion Arthroscopic tape augmentation repair of the anterior talofibular ligament is a safe and effective technique for treating lateral ankle instability.Compared to ATFL reconstruction,it offers advantages such as shorter surgical time,less radiation exposure,and faster recovery.
万方数据
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