不同的前交叉韧带状态对单髁膝关节置换术的影响:短期临床和功能结果

Meric Unal, Sabriye Ercan, Aydın Budeyri, Ahsen Oğul, Yurdagül Baygül, Cem Çetin
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引用次数: 0

摘要

目的:本研究的目的是比较无论前交叉韧带情况如何,应用单髁膝关节置换术治疗稳定膝关节的短期效果,以及应用单髁膝关节置换术和前交叉韧带重建联合手术治疗前交叉韧带缺失伴前部不稳定病例的效果,并确定前交叉韧带的情况和功能对手术成功的影响。患者和方法:研究纳入了 2013-2015 年接受手术并前来随访的 105 例患者中的 80 例,并将患者分为四组。术前和术后进行 VAS 疼痛评分、KSS 评分、WOMAC 评分、OKS 问卷调查和关节活动范围测量。术后对照组进行了单腿站立测试、关节位置感测量和等速肌力测试。结果显示各组的人口统计学数据和随访情况差异无统计学意义(P˃0.05)。第 2 组-第 4 组和第 3 组-第 4 组的膝关节屈曲度在术前有统计学差异,但在术后无差异(p˃0.05)。虽然各组之间没有差异,但膝关节伸展方向的活动范围在所有四组中均有统计学意义的下降(p˂0.05)。第一组术后疼痛感最强,第三组最小。在闭眼测试中,第 1 组和第 3 组的差异有统计学意义(p˂0.05):结论:功能性前交叉韧带的存在有望对手术效果产生积极影响,尤其是对活动量期望较高的年轻患者而言。患者的前交叉韧带断裂是原发性还是继发性的,以及他/她的活动期望值,都应在手术方法的选择中发挥有效作用。
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The Impact of Different Anterior Cruciate Ligament Status on Unicompartmental Knee Arthroplasty: Short Term Clinical and Functional Results
Purpose: Purpose of this study is to compare the short-term results of unicompartmental knee arthroplasty applied stable knees regardless of the condition of the ACL and the application of unicompartmental knee arthroplasty and ACL reconstruction combined surgery applied to ACL deficient cases with anterior instability and to identify the condition and function of the ACL for success in this surgery. Patients and Methods: 80 out of the 105 patients who were operated in 2013-2015 and came for follow-up were included in the study and the patients were divided into four groups. The VAS pain score, KSS Score, WOMAC score, OKS questionnaires and joint range of motion measurements were conducted pre-operatively and post-operatively. One leg standing test, joint position sense measurement, and isokinetic muscle strength test were performed in post-operative controls. Results: There was no statistically significant difference between the demographic data and follow-up of the groups (p˃0.05). While there was a statistically significant difference in knee flexion between Group 2-Group 4 and Group 3-Group 4 in the pre-operative period, no difference was found in the post-operative period (p˃0.05). While there was no difference among the groups, knee joint range of motion in direction of extension declined in a statistically significant way in all four groups (p˂0.05). Pain felt postoperatively was the most in Group 1 and the least in Group 3. A statistically significant difference was found between Group 1 and Group 3 in the test performed with the eyes closed (p˂0.05). Conclusion: The presence of a functional anterior cruciate ligament is expected to make a positive contribution to surgical results especially in young patients with high activity expectation. Whether the patient’s ACL rupture is primary or secondary and his/her activity expectation should be effective in the choice of a surgical method.
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