加速康复方案指导下前交叉韧带重建术手术时机对术后膝关节僵硬风险的影响

发布时间：2018-01-17 18:09

本文关键词：加速康复方案指导下前交叉韧带重建术手术时机对术后膝关节僵硬风险的影响　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:比较加速康复方案指导下的早期前交叉韧带重建术和晚期前交叉韧带重建术的术后僵硬风险分析非接触性ACL损伤患者术前双侧膝关节的TT-TG值差异及手术前后TT-TG值的变化。方法:回顾性分析2011年2月至2013年12月于我院行ACL重建术的29例患者手术前后及对照组33例的MRI资料,于轴位测量TT-TG值。ACL组患者术后随访一年以上,根据膝关节功能评分及稳定性评估手术效果。各组间计量资料采用独立样本t检验,计数资料采用χ2检验分析。结果:早期组和晚期组术后关节恢复情况差异无统计学意义(P0.05);ACL重建术后,膝关节旋转及内翻的情况得到明显改善,术后TT-TG值为11.19,减小至健侧膝关节水平。结论:在术后加速康复方案的指导下,早期前交叉韧带重建术与晚期前交叉韧带重建术相比,术后僵硬风险的差异无统计学意义。ACL组患侧膝术前的TT-TG值大于健侧膝及对照组,提示较大的TT-TG值可能是前十字韧带损伤的解剖学病因之一;患侧肢体前十字韧带重建术后的TT-TG值减小,提示ACL重建术可重建胫股关节的自然状态关系,TT-TG值可为ACL重建术后膝关节稳定性的评价提供准确的量化指标,具体量化方法仍需后续研究进一步确定。
[Abstract]:Objective:. Comparison of postoperative stiffness risk between early anterior cruciate ligament reconstruction and late anterior cruciate ligament reconstruction under the guidance of accelerated rehabilitation; differences in TT-TG values of bilateral knee joints in patients with non-contact ACL injury before operation; Changes of TT-TG before and after operation. Methods:. The MRI data of 29 patients undergoing ACL reconstruction in our hospital from February 2011 to December 2013 and 33 patients in the control group before and after operation were analyzed retrospectively. The patients in the TT-TG group were followed up for more than one year after operation. The results of operation were evaluated according to the knee joint function score and stability. The measured data of each group were measured by independent sample t-test. The count data were analyzed by 蠂 2 test. Results: there was no significant difference in postoperative joint recovery between early group and late group (P 0.05). After ACL reconstruction, the rotation and varus of knee joint were obviously improved, and the TT-TG value was 11.19, which was reduced to the level of healthy knee joint. Conclusion: under the guidance of postoperative accelerated rehabilitation program. There was no significant difference in postoperative stiffness risk between early anterior cruciate ligament reconstruction and late anterior cruciate ligament reconstruction. The preoperative TT-TG value of affected knee in ACLgroup was higher than that in healthy knee and control group. It is suggested that the larger TT-TG value may be one of the anatomical causes of anterior cruciate ligament injury. The TT-TG value decreased after anterior cruciate ligament reconstruction, suggesting that ACL reconstruction can reconstruct the natural state of tibiofemoral joint. The TT-TG value can provide an accurate quantitative index for the evaluation of knee joint stability after ACL reconstruction.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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