Long-Term Clinical Efficacy of Arthroscopy with Limited Incision in the Treatment of Knee Dislocation with Multiple Ligament Injuries

Yuqiang Huang, Wanan Qin, Baoqing Tang, Gejin Wei
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Abstract

This study retrospectively analyzes the long-term clinical efficacy of single-stage arthroscopy-assisted surgery with limited incision in the treatment of knee dislocation (KD) with multiple ligament injuries (MLI). A total of 19 patients diagnosed with MLI at the First Affiliated Hospital of Guangxi Medical University and the 923th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China from March 2013 to May 2015 were included in this study. The functional levels were assessed using the Lysholm Knee Scoring Scale, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Tegner Activity Score, and range of knee motion preoperatively. Non-parametric and Friedman tests were employed to analyze the surgical outcomes. The Lysholm scores increased from a preoperative value of 43.00 (95% confidence interval: 31.00, 50.00) to 88.00 (82.00, 95.00) at the post-operative follow-up of 10–36 months, and further improved to 90.00 (78.00, 98.00) after 8-year follow-up period. The IKDC scores increased from a preoperative value of 32.20 (28.70, 35.60) to 80.50 (60.90, 86.20) at 10–36 months post-operatively and further improved to 86.90 (69.00, 93.10) after 8-year follow-up period. The Tegner scores showed improvement from a preoperative value of 0.00 (0.00, 1.00) to 5.00 (3.00, 5.00) at 10–36 months postoperatively and to 4.0 (3.00, 5.00) after 8-year follow-up period. The ranges of active knee motion increased from preoperative 35.00 (30.00, 40.00) to 130.00 (120.00, 135.00) at 10–36 months and 8 years postoperative follow-up. In conclusion, it is recommended to adopt arthroscopy with limited incision for restoring knee joint stability and motor function.
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关节镜有限切口治疗膝关节脱位合并多处韧带损伤的长期临床疗效
本研究回顾性分析了单期关节镜辅助下有限切口手术治疗膝关节脱位(KD)合并多发性韧带损伤(MLI)的长期临床疗效。本研究纳入了2013年3月至2015年5月期间在广西医科大学第一附属医院和中国人民解放军联合后勤保障部队第923医院确诊的19例多发性韧带损伤患者。术前采用 Lysholm 膝关节评分量表、国际膝关节文献委员会(IKDC)膝关节主观评价表、Tegner 活动评分和膝关节活动范围对患者的功能水平进行评估。采用非参数检验和弗里德曼检验分析手术结果。Lysholm 评分从术前的 43.00(95% 置信区间:31.00,50.00)上升到术后随访 10-36 个月时的 88.00(82.00,95.00),并在 8 年随访期后进一步提高到 90.00(78.00,98.00)。IKDC 评分从术前的 32.20(28.70,35.60)提高到术后 10-36 个月的 80.50(60.90,86.20),并在 8 年随访期后进一步提高到 86.90(69.00,93.10)。Tegner 评分从术前的 0.00(0.00,1.00)提高到术后 10-36 个月时的 5.00(3.00,5.00),并在 8 年随访后提高到 4.0(3.00,5.00)。膝关节主动活动范围从术前的 35.00(30.00,40.00)增加到术后 10-36 个月和术后 8 年随访时的 130.00(120.00,135.00)。总之,建议采用有限切口的关节镜手术来恢复膝关节的稳定性和运动功能。
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