不同手术时机对前交叉韧带损伤术后膝关节功能的影响

目的 探讨伤后手术时机对前交叉韧带损伤术后膝关节活动度及稳定性的影响。 方法 分析2012年1月-2015年6月在浙江省金华广福医院接受治疗的76例单侧前交叉韧带损伤患者的临床资料,观察组(35例)患者在入院后3周内进行手术,对照组(41例)患者在入院后超过3周进行手术。比较2组患者手术前后关节活动度、Tegner、Lysholm、IKDC评分的差异,术后采用Kt2000测量仪测量手术前后胫骨前后移动距离,并对2组患者术后并发症进行定期随访,比较术后并发症发生情况。 结果 2组患者手术前后关节活动度、Tegner、Lysholm及IKDC评分比较,差异均无统计学意义(P>0.05)。观察组患者术后关节活动度、Tegner、Lysholm及IKDC评分明显高于对照组,差异均具有统计学意义(P<0.05);2组患者手术前后Kt2000屈膝30°、90°133.32 N下胫骨前后移动距离明显小于术前,差异均具有统计学意义(P<0.05)。观察组患者术后屈膝30°、90°133.32 N下胫骨前后移动距离与对照组相比,差异均无统计学意义(P>0.05)。对照组患者术后并发症发生率明显高于观察组,差异具有统计学意义2.86%(1/35) vs.12.20%(5/41);log-rank χ2=3.891,P=0.048]。 结论 伤后3周内进行前交叉韧带重建术可以有效保护患者膝关节的活动度及稳定性,有效避免术后膝关节半月板损伤及膝关节粘连的发生。 

Effects of surgery at different opportune moment on postoperative knee joint function in patients with anterior cruciate ligament injury

Objective To explore the influence of surgery at different opportune moment on postoperative knee joint function in patients with anterior cruciate ligament injury. Methods The clinical data of 76 patients with unilateral anterior cruciate ligament (ACL) injury treated in our hospital from January, 2012 to June, 2015 were analyzed, 35 patients who underwent surgery within 3 weeks after admission were assigned into the observation group, and 41 patients who underwent surgery over 3 weeks after admission were assigned into the control group. The range of motion, Tegner, Lysholm and IKDC scores of the two groups before and after the operation were compared. The anteroposterior distances of the tibia were measured by Kt2000 instrument before and after the operation, and the complications of both groups were followed up regularly, and the postoperative complications were compared. Results The difference in Tegner, Lysholm and IKDC score before and after the surgery in each group was not statistically significant (P>0.05). The activity, Tegner, Lysholm and IKDC scores in the observation group were significantly higher than those in the control group, the difference was statistically significant (P<0.05); the tibial anteroposterior movement distance by using Kt2000 knee joint arthrometers at 30° and 90° of flexion with a force of 133.32 N in both groups were significantly smaller than the preoperative level, the differences were statistically significant (P<0.05). After the operation, there was no significant difference in the tibial anteroposterior movement distance at 30° and 90° of flexion with a force of 133.32 N, (P>0.05). The incidence of postoperative complications in the control group was significantly higher than that in the observation group, the difference was statistically significant (1/35, 2.86% vs 5/41, 12.20%; log-rank χ2=3.891, P=0.048). Conclusion Anterior cruciate ligament reconstruction surgery can effectively protect the activity and stability of the knee joint patients within 3 weeks after injury, it can effectively avoid the occurrence of meniscus injury of knee joint and knee joint adhesion after operation.