摘要
目的:研究膝关节生理性后外侧旋转松弛对膝关节前交叉韧带重建术后临床效果的影响。方法:对113例在2010年至2016年行膝关节前交叉韧带重建术的患者根据膝关节屈曲90°位时胫骨外旋的角度分成3组。组1为<40°,组2为40°～50°,组3为≥50°.韧带稳定性的评估分别由Lanchman试验、轴移试验以及KT-2000arthrometer试验评价。膝关节功能由Lysholm评分量表及国际膝关节功能委员会(IKDC)评分量表评分。临床效果由患者术前评分与术后24个月后评分结果比较评价。结果:膝关节术后关节错动在不同的组间差异有统计学意义(P<0.001)。用Post hoc检测证实,与组1、组2比较组3中膝关节前移度增加。膝关节外旋角度达到90°时,明显会影响膝关节向前轴移(r=0.428,P=0.007)。然而,它却对Lysholm评分及IKDC评分有相反的影响,分别为(r=-0.146,P=0.015)和(r=-0.205,P=0.003)。结论:膝关节屈曲90°时胫骨外旋度对膝关节前叉重建术后关节稳定性及功能评分具有负面影响。在前叉重建术后的患者中,胫骨外旋角度≥50°的患者相比胫骨外旋角度<50°的患者具有较差的功能结果及较大的关节前移度。
Objective ： The purpose of this study was to investigate the effect of physiological posterolateral rotation relaxa-tion on the clinical outcome of anterior cruciate ligament （ACID reconstruction. Methods：We retrospectively studied 113patients who underwent anterior cruciate ligament reconstruction from 2010 to 2016. Patients were categorized into threegroups according to the degree of tibial external rotation at 90° of knee flexion：Group 1 （〈40°）, Group 2 （40°-50°）,and Group 3 （≥50~）. Ligament stability was determined with use of the Lachman test, the pivot-shift test, and KT-2000arthrometer testing. The knee joint function was assessed by Lysholm score and the International Knee DocumentationCommittee （IKDC） scoring scale. The clinical effect was evaluated by the data obtained before surgery and at the 24-month follow-up visit. Results：In this study, there were significant differences in joint dislocation between different groupsafter knee joint operation （P〈0. 001）. Post hoc test confirmed that the knee joint forward motion increased in group 3,when compared with group 1 and group 2. The degree of external rotation at 90° was positively correlated with anteriorknee translation （r=0. 428, P= 0. 007）. However, there was an inverse correlation with the Lysholm knee scores （r=-0. 146, P=0. 015） and IKDC score （r=-0. 205, P=0. 003）. Conclusion：The stability and functional scores after ACLreconstruction had a negative correlation with the degree of external rotation of the tibia at 90°. After ACL reconstruction,patients with ≥50° of tibial external rotation had increased anterior translation and worse functional outcomes in compari-son with those who had 〈50° of tibial external rotation.
作者
朱涛
肖斌
白登彦
袁治国
ZHU Tao;XIAO Bin;BAI Dengyan;YUAN Zhiguo(Northwest Minzu University,Lanzhou 730000,China;Second Clinical Medical College,Northwest Minzu University,Lanzhou 730000,China.)
出处
《中国中医骨伤科杂志》
CAS
2018年第11期17-20,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
西北民族大学中央高校科研项目(31920170185)
关键词
膝关节
膝前交叉韧带
重建术
knee joint
anterior cruciate ligament
reconstruction
