关节镜下后交叉韧带重建术手术时机对临床疗效的影响

Impact of the timing of arthroscopic posterior cruciate ligament reconstruction on the clinical outcome

摘要:

目的 比较不同时机于关节镜下行后交叉韧带重建术的疗效和安全性。方法 回顾性分析2015年1月－2021年6月沈阳市骨科医院40例行后交叉韧带重建术的患者的临床资料。根据伤后手术时间不同将患者分为研究组（于3周内手术，n = 24）和对照组（超过3周手术，n = 16）。比较两组患者术前、术后8周和末次随访时的膝关节活动范围、国际膝关节文献委员会（IKDC）评分、视觉模拟评分（VAS）、Lysholm膝关节功能评分等。结果 两组患者术前与术后8周和末次随访时膝关节活动范围无明显差异（P > 0.05）；两组患者术前IKDC评分比较，差异无统计学意义（P > 0.05），术后8周和末次随访时比较，差异均有统计学意义（P < 0.05）；研究组术前VAS明显高于对照组，差异有统计学意义（P < 0.05），两组患者术后8周和末次随访时VAS比较，差异无统计学意义（P > 0.05）；两组患者术前Lysholm评分比较，差异无统计学意义（P > 0.05），研究组术后8周和末次随访时的Lysholm评分明显高于对照组，差异有统计学意义（P < 0.05）；两组患者并发症发生率比较，差异无统计学意义（P > 0.05）。结论 后交叉韧带断裂患者于3周内行后交叉韧带重建术，有利于术后患者膝关节功能的恢复。

Abstract:

Objective To compare the efficacy and safety of posterior cruciate ligament reconstruction under arthroscopy at different times.Methods 40 patients with posterior cruciate ligament reconstruction from January 2015 to June 2021 were selected, and the included patients were divided into two groups according to the different operation time after injury: the study group (n = 24, within 3 weeks) and the control group (n = 16, over 3 weeks). The Knee range of motion, The International Knee Documentation Committee (IKDC) score, visual analogue scale (VAS) and Lysholm knee function score were compared between the two groups before surgery, 8 weeks after surgery and at the last follow-up.Results There was no significant difference in knee range of motion between the two groups before surgery, 8 weeks after surgery and at the last follow-up (P > 0.05). There was no significant difference in IKDC score between the two groups before surgery (P > 0.05), but there were significant difference at 8 weeks and the last follow-up after surgery (P < 0.05). The VAS of the study group before the operation was significantly higher than that of the control group (P < 0.05), there were no significant differences between the two groups 8 weeks after surgery and at the last follow-up (P > 0.05). There was no statistically significant difference in Lysholm score between the two groups before the operation (P > 0.05), Lysholm score in the study group 8 weeks after surgery and at the last follow-up were significantly higher than those in the control group, with statistical significance (P < 0.05). There was no significant difference in the complication rate between the two groups (P > 0.05).Conclusion Posterior cruciate ligament reconstruction within 3 weeks for patients with posterior cruciate ligament rupture is beneficial to the recovery of postoperative knee function.