| 半月板成形对前交叉韧带重建术后膝关节功能恢复影响的病例对照研究 |
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Received:December 09, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 傅利锋 |
FU Li-feng |
绍兴市柯桥区中医医院, 浙江 绍兴 312030 |
Chinese Medicine Hospital of Keqiao District, Shaoxing 312030, Zhejiang, China |
fulifeng2016@163.com |
| 胡劲涛 |
HU Jin-tao |
绍兴市柯桥区中医医院, 浙江 绍兴 312030 |
Chinese Medicine Hospital of Keqiao District, Shaoxing 312030, Zhejiang, China |
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| 王政 |
WANG Zheng |
绍兴市柯桥区中医医院, 浙江 绍兴 312030 |
Chinese Medicine Hospital of Keqiao District, Shaoxing 312030, Zhejiang, China |
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| 陈鑫 |
CHEN Xin |
绍兴市柯桥区中医医院, 浙江 绍兴 312030 |
Chinese Medicine Hospital of Keqiao District, Shaoxing 312030, Zhejiang, China |
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| 期刊信息：《中国骨伤》2017年30卷，第8期，第721-725页 |
| DOI：10.3969/j.issn.1003-0034.2017.08.008 |
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目的：观察半月板成形对前交叉韧带重建术后膝关节功能和稳定性的影响。
方法：收集2013年1月至2015年1月接受符合纳入标准的前交叉韧带重建患者64例，分为对照组和成形组。对照组30例，为半月板完整的前交叉韧带重建患者，男24例，女6例；年龄22~43岁；左侧17例，右侧13例；随访时间12~19个月。成形组34例，为接受半月板成形的前交叉韧带重建患者，男27例，女7例；年龄23~42岁；左侧22例，右侧12例；随访时间12~20个月。观测术前患侧胫骨前移度、膝关节功能评分及末次随访时健侧和患侧胫骨前移度、主动本体感觉和膝关节功能评分。胫骨前移度采用KT 1000测量，膝关节功能采用Lysholm评分量表和KOOS量表评估，主动本体感觉测量膝关节重复30°、45°、60°的3个角度的误差。
结果：对照组术后患侧胫骨前移度（1.4±0.2） mm，低于成形组的（2.2±0.4） mm（P<0.05）。对照组和成形组术后膝关节Lysholm总分分别为93.7±2.7和92.3±3.0，均较术前的52.8±3.9和51.6±5.1提高（P<0.05），但术后对照组Lysholm总分与成形组比较差异无统计学意义（P>0.05）。在KOOS量表的评分中，对照组术后症状、疼痛、日常生活、运动能力及生活质量分别为90.7±5.5、93.2±4.3、96.8±2.2、90.9±5.3和91.8±4.5，高于术前的72.7±6.0、70.6±7.3、72.5±7.4、52.8±5.4和36.2±6.5（P<0.05）；成形组术后症状、疼痛、日常生活、运动能力及生活质量分别为88.9±5.8、92.6±3.5、96.5±2.1、89.3±7.2和90.6±4.1，高于治疗前的71.9±5.1、71.2±7.1、71.3±6.2、53.1±6.1和35.6±4.7（P<0.05），对照组术后KOOS量表各项评分与成形组比较差异无统计学意义（P>0.05）。术后对照组健侧主动本体感觉误差为（12.2±3.4）°，与成形组健侧的（12.8±3.2）°相比差异无统计学意义（P>0.05）；对照组患侧主动本体感觉误差为（13.5±3.7）°，小于成形组患侧的（17.1±4.2）°（P<0.05）；对照组患侧主动本体感觉误差与健侧比较差异无统计学意义（P>0.05），而成形组患侧主动本体感觉误差明显大于健侧（P<0.05）。
结论：半月板成形对前交叉韧带重建术后患者中短期内膝关节功能无显著影响，但膝关节本体感觉及稳定性减弱。 |
| [关键词]:半月板,胫骨 膝关节 关节成形术 前交叉韧带 病例对照研究 |
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| Case-control study on the effect of meniscus shaping on knee function after anterior cruciate ligament reconstruction |
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Abstract:
Objective: To observe the effect of the meniscus shaping on the knee function and stability after anterior cruciate ligament reconstruction(ACLR).
Methods: A total of 64 ACLR patients were included from January 2013 to January 2015. The control group was the ACLR patients with intact meniscus,in which 24 males and 6 females. The mean age was(32.8±5.5) years old(ranged,22 to 43 years old). The injury side was left on 17 cases and right on 13 cases. The mean follow-up time was(15.2±2.8) months(ranged,12 to 19 months). The shaping group was the ACLR patients with meniscus shaping,in which 27 males and 7 females. The mean age was (33.1±4.2) years old (ranged,23 to 42 years old). The injury side was on the left in 22 case and right in 12 cases. The mean follow-up time was (16.0±3.1) months (ranged,12 to 20 months). The preoperative anterior tibia shift and knee joint function,as well as anterior tibia shift,knee joint function and active proprioception at last follow-up time were observed. The anterior tibia shift was measured by KT-1000. The knee joint function was assessed by Lysholm score and KOOS score. The errors of active proprioception were measured at 30°,45° and 60° knee flexion.
Results: Postoperative anterior tibia shift of the affected side was (1.4±0.2) mm,which was lower than (2.2±0.4) mm in shaping group(P<0.05). The postoperative total Lysholm scores of the control group and the shaping group were 93.7±2.7 and 92.3±3.0 respectively,which were higher than 52.8±3.9 and 51.6±5.1 preoperatively(P<0.05),but there were no significant differences between two groups(P>0.05). In the KOOS score,the postoperative symptoms,pain,daily life,exercise capacity and life quality in control group were 90.7±5.5,93.2±4.3,96.8±2.2,90.9±5.3,91.8±4.5 respectively,which were higher than 72.7±6.0,70.6±7.3,72.5±7.4,52.8±5.4,36.2±6.5 preoperatively(P<0.05);the postoperative symptoms,pain,daily life,exercise capacity and life quality in the shaping group were 88.9±5.8,92.6±3.5,96.5±2.1,89.3±7.2,90.6±4.1 respectively,which were higher than 71.9±5.1,71.2±7.1,71.3±6.2,53.1±6.1,35.6±4.7 preoperatively(P<0.05). No significant differences were observed in each postoperative item of KOOS between the two groups(P>0.05). No significant differences were observed in the postoperative active proprioception error of contralateral side between the control group(12.2±3.4)ånd shaping group(12.8±3.2)°(P>0.05). The error of active proprioception in the affacted side of the control group was(13.5±3.7)°,which was lower than that in the shaping group(17.1±4.2)°(P<0.05). In control group,there was no significant difference in the active proprioception error between two sides(P>0.05). While in shaping group,the error of active proprioception in the affacted side was significantly greater than that in the contralateral side(P<0.05).
Conclusion: In short and medium term,meniscus shaping has no effect on knee joint function in patients with ACLR,but it impairs the knee proprioception and stability. |
| KEYWORDS:Meniscus,tibial Knee joint Arthroplasty Anterior cruciate ligament Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 傅利锋,胡劲涛,王政,陈鑫.半月板成形对前交叉韧带重建术后膝关节功能恢复影响的病例对照研究[J].中国骨伤,2017,30(8):721~725 |
| 英文格式: | FU Li-feng,HU Jin-tao,WANG Zheng,CHEN Xin.Case-control study on the effect of meniscus shaping on knee function after anterior cruciate ligament reconstruction[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(8):721~725 |
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