早期关节镜辅助一期重建膝关节多韧带损伤的重要性

目的探讨膝关节镜下多韧带一期重建的临床疗效,并对比分析早期和延迟重建手术对膝关节多韧带损伤的疗效。方法回顾性分析99例膝关节镜下多韧带一期重建患者的病例资料,根据膝关节初次外伤至手术间隔时间分为早期手术组(<21 d)和延迟重建组(≥21 d),收集患者的术后并发症情况,记录并对比分析两组患者术前及术后的膝关节疼痛视觉模拟评分(VAS)、Lysholm评分和国际膝关节文献委员会膝关节评估表(IKDC)。结果所有患者手术切口均Ⅰ期愈合,无早期并发症发生。所有患者膝关节VAS评分、Lysholm评分和IKDC评分均明显优于术前(P=0.000)。进一步对比分析早期和延迟重建组患者的VAS评分、Lysholm评分和IKDC评分,早期手术组患者VAS评分低,Lysholm评分和IKDC评分较高,但仅IKDC评分明显优于延迟重建组(P<0.05)。结论对于膝关节多韧带手术患者,应用膝关节镜一期多韧带重建能更好地恢复膝关节的稳定和功能,相比延迟重建手术患者,早期手术干预有更好的临床预后。

Importance of early one-stage arthroscopically assisted reconstruction in multi-ligament knee injuries

Objective To explore the clinical outcome of one-stage arthroscopically assisted ligament reconstruction in multi-ligament knee injuries, and comparing early versus delayed surgical treatment of multiligament knee injuries. Methods 99 patients who underwent arthroscopic multi-ligament knee injuries reconstruction were evaluated retrospectively. According to time from initial trauma to surgery less than 21 days grouped as early surgical group(44 patients) and 21 days or longer defined as delayed surgical group(45 patients). The incidence of surgical complications was statistically analyzed, the VAS scores, knee joint Lysholm scores and IKDC scores before and after operation in each group were recorded and compared. Results All the surgical incisions healed by first intention, and there was no early complications. VAS scores, knee joint Lysholm scores and IKDC scores were improved significantly at the last follow-up(P = 0.000). The VAS scores, knee joint Lysholm scores and IKDC scores before and after operation in each group were analyzed, the VAS scores of the last follow-up in the early surgical group were lower comparing with those in delayed surgical groups, and knee joint Lysholm scores and IKDC scores were higher improved at the last follow-up, however, significant differences were only noted on IKDC scores between the early or delayed surgical group(P < 0.05). Conclusion For multi-ligament knee injuries, using onestage arthroscopic surgery can achieve good stability of the knee and significantly improved knee function, and early surgical intervention would result in superior functional outcomes, when compared to delayed surgical intervention.