髌腱骨移植与腘绳肌移植在前交叉韧带重建手术中的术后即刻疼痛
Immediate post-operative pain in anterior cruciate ligament reconstruction surgery with bone patellar tendon bone graft versus hamstring graft.
作者信息
Gupta Ravi, Kapoor Dheeraj, Kapoor Love, Malhotra Anubhav, Masih Gladson David, Kapoor Anil, Joshi Shweta
机构信息
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
Department of Anaesthesia, Government Medical College and Hospital, Chandigarh, India.
出版信息
J Orthop Surg Res. 2016 Jun 8;11(1):67. doi: 10.1186/s13018-016-0399-5.
BACKGROUND
Pain in the immediate post-operative period after anterior cruciate ligament (ACL) surgery, apart from an unpleasant experience for the patient, can act as a barrier for static quadriceps contractions and optimum execution of the initial rehabilitation protocol resulting in slow recovery and a later return to full function for a sportsperson. There is no report in the literature comparing pain in the immediate post-operative period after using the two most widely used autografts, bone patellar tendon bone (BPTB) graft and hamstring graft.
METHODS
The present study compared the visual analogue scale (VAS) pain score in the immediate post-operative period after arthroscopic ACL reconstruction with the BPTB and hamstring autografts. Both groups consisted of 50 patients each. The mean age of the BPTB and hamstring cohorts was 26.9 ± 7.3 years (age range 18-59 years) and 26.7 ± 9.0 years (age range 17-52 years), respectively. Unpaired t test was applied to compare pain scores between the BPTB and hamstring cohorts.
RESULTS
In the present study, patients in the BPTB cohort showed higher mean pain scores across all the post-operative time intervals except at 6 h. However, the difference in the mean VAS pain score at post-operative 6, 12,18, 24, 36 and 48 h in the two groups was statistically not significant (p value of 1, 0.665, 0.798, 0.377, 0.651 and 0.215 at 6, 12, 18, 24, 36 and 48 h, respectively).
CONCLUSIONS
Our study concludes that the arthroscopic ACL reconstruction with BPTB autograft and hamstring autograft is associated with similar pain in the immediate post-operative period. As a result, aggressive physiotherapy regime is not affected by the type of graft being used for ACL reconstruction, as the pain scores in the immediate post-operative period are similar for both techniques.
TRIAL REGISTRATION
Clinical Trials Registry-India, CTRI/2016/01/006502.
背景
前交叉韧带（ACL）手术后的即刻疼痛，除了给患者带来不愉快的体验外，还可能成为静态股四头肌收缩的障碍，影响初始康复方案的最佳执行，导致恢复缓慢，运动员难以完全恢复功能。文献中没有关于比较两种最常用的自体移植物，即骨-髌腱-骨（BPTB）移植物和腘绳肌移植物术后即刻疼痛情况的报道。
方法
本研究比较了关节镜下ACL重建术后使用BPTB和腘绳肌自体移植物的即刻视觉模拟量表（VAS）疼痛评分。两组各有50例患者。BPTB组和腘绳肌组的平均年龄分别为26.9±7.3岁（年龄范围18 - 59岁）和26.7±9.0岁（年龄范围17 - 52岁）。采用独立样本t检验比较BPTB组和腘绳肌组的疼痛评分。
结果
在本研究中，除6小时外，BPTB组患者在所有术后时间间隔的平均疼痛评分均较高。然而，两组在术后6、12、18、24、36和48小时的平均VAS疼痛评分差异无统计学意义（6、12、18、24、36和48小时的p值分别为1、0.665、0.798、0.377、0.651和0.215）。
结论
我们的研究得出结论，关节镜下使用BPTB自体移植物和腘绳肌自体移植物进行ACL重建术后即刻疼痛相似。因此，积极的物理治疗方案不受用于ACL重建的移植物类型的影响，因为两种技术术后即刻的疼痛评分相似。
试验注册
印度临床试验注册中心，CTRI/2016/01/006502
Zotero 插件