前交叉韧带前内入路解剖单束重建与过顶位单束重建的疗效比较

Effectiveness comparison of using anteromedial portal anatomical single-bundle reconstruction and over-the-top single bundle reconstruction of anterior cruciate ligament

摘要:

摘要：目的 比较解剖位单束（ASB）重建与过顶位单束（OSB）重建前交叉韧带（ACL）的临床疗效。方法 回顾性分析2015年3月－2017年9月该院收治的44例ACL断裂的单膝ACL损伤患者的临床资料。采用ASB重建手术22例（ASB组），采用OSB重建手术22例（OSB组）。两组患者性别、年龄、病程、国际膝关节文献委员会（IKDC）评分和Lysholm评分等一般资料比较，差异均无统计学意义（P >0.05），具有可比性。结果 两组患者均获得随访，时间为6～12个月，平均8.6个月，术后6个月随访时，在膝关节活动度方面，ASB组无屈曲、伸直受限；OSB组1例伸直受限5°，无屈曲受限；在Lachman试验方面，ASB组均为阴性，OSB组术后Ⅰ度3例，但止点硬。两组Lachman试验阴性率比较，差异无统计学意义（P >0.05）；两组轴移试验阴性率比较，差异有统计学意义（P <0.05）。两组IKDC评分、Lysholm评分术前术后比较，差异均有统计学意义（P <0.05）；两组术后6个月IKDC评分、Lysholm评分比较，差异均无统计学意义（P >0.05）。结论 关节镜下采用ASB重建ACL，在控制膝关节旋转稳定性方面优于传统OSB重建。

Abstract:

Abstract: Objective To compare the clinical outcomes of anatomical single-bundle (ASB) and over-the-top single-bundle (OSB) reconstruction of the anterior cruciate ligament (ACL). Methods Between March 2015 and September 2017, 44 patients with ACL injury underwent arthroscopic ACL reconstruction. ASB ACL reconstruction was performed in 22 cases (ASB group) and OSB ACL reconstruction in 22 cases (OSB group). There was no significant difference in gender, age, disease duration, International Knee Documentation Committee (IKDC) score, Lysholm score difference between 2 groups (P > 0.05). Results 44 patients were followed up 6 ~ 12 months(mean, 8.6 months). After 6 months of follow-up, the active joint flexion degree: no flexion limitation and extension limitation in ASB group, 1 case presented 5° extension limitation in OSB group with no flexion limitation; Lachman test: all cases presented negative Lachman test in ASB group while 3 cases positive for degree Ⅰ in OSB group, but the terminal spot was hard. There was no significant difference in the Lachman test between two groups (P > 0.05), but differences in pivot shift test between two groups were statistically significant (P < 0.05). There were significant differences compared before and after operation in the IKDC score (P < 0.05), but there was no significant difference between two groups at 6 months after operation (P > 0.05). Conclusion The effectiveness of arthroscopic ACL reconstruction with ASB is superior to OSB in controlling knee rotational stability.