摘要
目的比较关节镜下前交叉韧带(anterior cruciate ligament,ACL)全内重建中,由外向内技术和经前内侧入路技术制作股骨隧道对术后临床疗效的差异。方法收集2020年2月至2022年6月徐州市中心医院运动医学科收治的60例ACL断裂患者,根据手术技术的不同,分为观察组(由外向内技术)30例和对照组(经前内侧入路技术)30例。其中观察组男20例,女10例;年龄24~37岁,平均(29.30±4.00)岁;对照组男17例,女13例;年龄23~40岁,平均(29.70±4.21)岁;比较两组患者术前、术后6个月、12个月膝关节Lysholm评分和美国膝关节协会评分(knee society score,KSS);比较两组患者术前和末次随访膝关节松弛度;随访期间记录两组患者伤口感染、肌腱松动、术后再次翻修等情况。结果所有患者均获随访,随访时间12~18个月,观察组平均随访(15.37±1.61)个月,对照组平均随访(14.97±1.56)个月;术后12个月,观察组膝关节前抽屉试验、Lachman试验和轴移试验结果与对照组患者相似,差异无统计学意义(P>0.05);术后6个月和12个月两组患者膝关节Lysholm评分和KSS评分相似,差异无统计学意义(P>0.05);随访期间,两组患者均未发生伤口感染、肌腱松动、术后再次翻修等情况。结论ACL全内重建中,选择经前内侧入路技术或由外向内技术制作股骨隧道均能实现股骨隧道的解剖定位,术后两组患者膝关节功能恢复良好,短期疗效均可接受。
Objective To compare the differences in postoperative clinical efficacy between the outside-in technique and the anteromedial portal technique in arthroscopic all-inside technique for creating femoral tunnels of the anterior cruciate ligament(ACL)reconstruction.Methods A retrospective analysis was conducted on 60 patients with ACL rupture treated at the Department of Sports Medicine,Xuzhou Central Hospital,between February 2020 and June 2022.Patients were divided into two groups:The observation group(n=30,treated with the outside-in technique)and the control group(n=30,treated with the anteromedial portal technique).Demographics included 20 males and 10 females in the observation group[age range:24~37 years,mean age:(29.30±4.00)years]and 17 males and 13 females in the control group[age range:23~40 years,mean age:(29.70±4.21)years].Clinical outcomes were evaluated using the Lysholm knee scores and knee society scores(KSS)at baseline,6 months,and 12 months postoperatively.Knee joint laxity was assessed preoperatively and at the final follow-up.During the follow-up period,the incidence of wound infections,tendon loosening,and postoperative revisions were recorded for both groups.Results All patients completed a follow-up period ranging from 12 to 18 months,with a mean follow-up duration of(15.37±1.61)months in the observation group and(14.97±1.56)months in the control group.At 12 months postoperatively,the knee joint anterior drawer test,Lachman test,and axial shift test results were comparable between the observation group and the control group,demonstrating no statistically significant difference(P>0.05).The Lysholm knee scores and KSS at 6 and 12 months postoperatively were similar in both groups,with no statistically significant difference observed(P>0.05).Throughout the follow-up period,neither group reported any cases of wound infection,tendon loosening,or the need for postoperative revision.Conclusion Both the anteromedial portal technique and the outside-in technique,when employed in arthroscopic all-inside reconstruction of the anterior cruciate ligament,effectively achieve anatomical positioning of the femoral tunnel.Following surgery,patients in both groups experienced satisfactory recovery of knee joint function,with comparable short-term therapeutic outcomes.This suggests that both techniques are viable options for ACL reconstruction,offering comparable efficacy and outcomes in the short-term.
作者
张军
朱伟伟
徐付国
赵一朗
王涛
Zhang Jun;Zhu Weiwei;Xu Fuguo;Zhao Yilang;Wang Tao(Department of Sports Medicine,Xuzhou Central Hospital Affiliated to Southeast University,Xuzhou 221009,China)
出处
《实用骨科杂志》
2024年第9期793-797,共5页
Journal of Practical Orthopaedics
关键词
前交叉韧带
损伤
全内重建技术
经前内侧入路技术
anterior cruciate ligament injury
all inside reconstruction technique
anteromedial portal technique