关节镜下胫骨端保残重建治疗前交叉韧带损伤的疗效分析

目的 探讨关节镜下胫骨端保残重建治疗前交叉韧带（ACL）损伤的疗效。方法 选取2015年1月至2016年5月安徽医科大学第一附属医院收治的56例ACL损伤患者,按照随机数字表法分为胫骨端保残重建ACL组（保残组）和清除胫骨端韧带组（对照组）,术前及术后第12个月进行一次随访,分析比较两组患者国际膝关节评分委员会评分（IKDC）及本体感觉评分的差异。结果 保残组患者术前IKDC评分为（49.54±5.17）分,本体感觉评分为（16.14±1.04）分,术后第12个月IKDC评分为（89.61±5.21）分;本体感觉评分为（7.04±0.79）分。对照组患者术前IKDC评分为（48.64±5.26）分,本体感觉评分为（16.28±0.98）分,术后第12个月随访IKDC评分为（88.15±4.98）分,本体感觉评分（10.43±0.84）分。两组患者术后的IKDC和本体感觉评分均高于术前差异有统计学意义（P<0.05）。保残组术后的本体感觉评分高于对照组差异有统计学意义（P<0.05）。结论 关节镜下胫骨端保残单束重建ACL对膝关节本体感觉功能的恢复有积极作用。

Effectiveness of arthroscopic reconstruction with preservation of tibial ligamentremnantsin treatment of anterior cruciate ligament injury

Objective To explore the effectiveness of arthroscopic reconstruction with preservation of the tibial ligamentremnantsin the treatment of anterior cruciate ligament(ACL)injury.Methods A total of 56 patientswith ACL injury, ever treated in our hospitalbetween Jan 2015 and May 2016, were enrolled anddivided into two groups by means of random numbertable. Patients in the preservation group underwent ACL reconstruction with preservation of the tibial ligament remnants, and patients in the control group had their tibial ligament remnants resected. The scores of International Knee Documentation Committee (IKDC) and proprioceptive sensebefore operation and at 12 months after operation in both groups were assessed, and the differences between the two groups were compared and analyzed. Results In the preservation group, the preoperative scores of IKDC and proprioception were 49.54±5.17 and 16.14±1.04, respectively, and at 12 months after operation the scores were 89.61±5.21 and 7.04±0.79, respectively.In the control group, the preoperative scores of IKDC and proprioception were 48.64±5.26 and 16.28±0.98, respectively, and at 12 months after operation the scores were 88.15±4.98 and 10.43±0.84, respectively. The postoperative scores of IKDC and proprioception in both groups were significantly higher than those preoperative scores (all P<0.01). Compared with the control group, the preservation group had significantly higher postoperative score of proprioception (P<0.01). Conclusion Application of arthroscopic single-bundle ACL reconstructionwith preservation of tibial ligamentremnantsmight be advantageous to the recoveryof proprioceptive sense in knee joints.