目的 比较膝关节镜下使用3种不同股骨隧道位置行单束前交叉韧带(ACL)重建对术后5年主观功能的影响.方法 回顾性分析2012年1月至2017年12月国家体育总局运动医学研究所体育医院运动创伤外科收治的165例ACL断裂患者的临床资料,根据股骨隧道位置的不同将患者分为低位中心(LC)组、高位中心(HC)组和高位前内(HAM)组,对3组患者术前和术后5年国际膝关节评分委员会评分、Lysholm评分及术后的ACL-损伤后重返运动量表评分进行比较.结果 患者平均随访(60.2±1.52)个月(57～64个月).术后5年LC、HC、HAM组的国际膝关节文献委员会评分分别为(80.80±10.82)、(77.36±14.36)、(85.33±7.42)分,较术前均显著增加(P均=0.002),术后5年HAM组显著高于 LC 组和 HC 组(P=0.022,P=0.008).术后 5年LC、HC 和 HAM 组的 Lysholm 评分分别为(80.87±10.83)、(77.67±15.23)、(86.10±7.68)分,与术前比较均显著升高(P均=0.002),术后5年HAM组显著高于LC组和HC组(P=0.020,P=0.022).术后5年LC、HC和HAM组的ACL-损伤后重返运动量表评分分别为(70.39±17.26)、(73.58±16.81)、(83.73±11.10)分,HAM组显著高于LC组和HC组(P=0.014,P=0.038).结论 HAM点作为单束ACL股骨隧道重建位置,术后5年膝关节主观功能更好.因此,推荐HAM点做为ACL重建术的首选股骨隧道的定位点.
Subjective Functional Outcomes of Single-Bundle Anterior Cruciate Ligament Reconstruction With Different Femoral Tunnel Positions via Arthroscopy
Objective To compare the five-year subjective functional outcomes of single-bundle anteri-or cruciate ligament reconstruction(ACLR)with three different femoral tunnel positions under arthroscopic guid-ance.Methods A retrospective study was conducted on the clinical data of 165 patients who underwent ACLR at the Department of Sports Traumatology,Sports Hospital,National Institute of Sports Medicine,General Admin-istration of Sport of China from January 2012 to December 2017.According to femoral tunnel positions,the pa-tients were assigned into three groups of low centre(LC)section(n=53),high centre(HC)section(n=45),and high anterior medial(HAM)section(n=67).The three groups were compared before and 5 years after surgery regarding the following items:international knee documentation committee(IKDC)score,Lysholm score,and ACL-return to sport after injury(ACL-RSI)scale score.Results All patients were followed up for 57-64 months[(60.2±1.52)months].The IKDC scores in the LC,HC,and HAM groups 5 years after sur-gery were 80.80±10.82,77.36±14.36,and 85.33±7.42,respectively,and the scores were higher than those before surgery(all P=0.002).The HAM group had higher IKDC score than the LC and HC groups 5 years after surgery(P=0.022,P=0.008).The Lysholm scores in the LC,HC,and HAM groups 5 years af-ter surgery were 80.87±10.83,77.67±15.23,and 86.10±7.68,respectively,which were higher than those before surgery(all P=0.002).Moreover,the HAM group had higher Lysholm score than the LC and HC groups(P=0.020,P=0.022).The ACL-RSI scores in the LC,HC,and HAM groups 5 years after surgery were 70.39±17.26,73.58±16.81,and 83.73±11.10,respectively,and the score was higher in the HAM group than in the LC and HC groups(P=0.014,P=0.038).Conclusions The ACL patients treated by ACLR with the HAM section had better rotational stability and subjective function 5 years after surgery.Therefore,we recom-mend the HAM section as the preferred femoral tunnel position in ACL reconstruction.
万方数据
维普
