摘要
目的 通过对前交叉韧带(ACL)重建术后2年以上的患者进行临床评估、本体感觉和运动表现的测试,评估ACL重建手术时机对运动表现与本体感觉恢复的影响.方法 对2015年1月至2021年1月于国家体育总局体育医院行ACL重建术且符合纳入标准的患者进行集中随访,收集患者术后资料.最终纳入56例符合纳排标准的患者:早期手术组(受伤至接受手术的时间≤3周)28例,延迟手术组(受伤至接受手术的时间＞3周)28例.比较两组患者基本资料、临床评估结果、本体感觉以及运动表现.结果 早期手术组ACL-伤后重返运动量表评分显著高于延迟手术组[(68.68±22.04)分比(55.82±24.87)分,P=0.045].膝关节活动度,轴移试验阳性率以及Tegner、Marx、Lysholm、膝关节损伤与骨关节炎评分和国际膝关节评分委员会评分结果差异均无统计学意义(P均＞0.05),虽然两组膝关节活动度差异无统计学意义,但早期手术组屈膝和伸膝受影响的比例有小于延迟手术组的趋势.运动表现(等速肌力测试、Y平衡测试、单腿跳测试)和本体感觉两组比较差异均无统计学意义(P均＞0.05).结论 早期行ACL重建术比延迟重建的患者有更好的心理、情绪及重返运动的信心,加速患者术后功能的康复.行ACL重建手术的时机对患者术后短期膝关节稳定性、膝关节功能、运动表现能力和本体感觉的恢复没有显著影响,建议早期重建ACL,以达到更好的临床效果.
Abstract
Objective To evaluate the effects of anterior cruciate ligament(ACL)reconstruction tim-ing on the motor performance and proprioception by clinical evaluation as well as proprioception and motor per-formance tests on the patients more than 2 years after ACL reconstruction.Methods The patients who underwent ACL reconstruction in the National Institute of Sports Medicine,General Administration of Sport of China from January 2015 to January 2021 and met the inclusion criteria were followed up,and the postoperative data were collected retrospectively.Fifty-six patients who met the inclusion criteria were included in this study and categorized into two groups:early surgery(n=28,who underwent ACL reconstruction ≤3 weeks after injury)and delayed surgery(n=28,who underwent ACL reconstruction＞3 weeks after injury).The basic information,clinical evaluation results,proprioception,and motor performance were compared between the two groups.Results The ACL return to sport after injury scale(ACL-RSI)score in the early surgery group was higher than that in the de-layed surgery group[(68.68±22.04)scores vs.(55.82±24.87)scores,P=0.045].There was no difference in the range of motion of the knee joint,the positive rate of pivot shift test,or the scores of Tegner,Marx,Ly-sholm,knee injury and osteoarthritis outcome score(KOOS),and international knee documentation committee(IKDC)between the two groups(all P＞0.05).Although there was no significant difference in range of motion of the knee joint between the two groups,the proportion of knee flexion and extension affected in the early surger-y group was smaller than that in the delayed surgery group.Neither motor performance(isokinetic strength test,Y-balance test,and single-leg jump test)nor proprioception had difference between the two groups(all P＞0.05).Conclusions Early ACL reconstruction outperformed delayed ACL reconstruction in improving the psy-chological health,emotions,and confidence in returning to sport,accelerating functional recovery of the pa-tients.The timing of ACL reconstruction has no significant effect on the short-term postoperative knee stability,knee function,motor performance,or proprioceptive recovery of the patients.Early ACL reconstruction is recom-mended for improving the clinical outcomes.
维普
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