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急性和慢性髌腱断裂一期手术修复后的长期功能结果:25例患者系列研究

Long-term functional outcomes after primary surgical repair of acute and chronic patellar tendon rupture: Series of 25 patients.

作者信息

Belhaj K, El Hyaoui H, Tahir A, Meftah S, Mahir L, Rafaoui A, Lmidmani F, Arsi M, Rahmi M, Rafai M, Garch A, Fadili M, Nechad M, El Fatimi A

机构信息

Department of physical medicine and rehabilitation, Ibn Rochd university hospital, Casablanca, Morocco.

Department of orthopedics and traumatology (P32), Ibn Rochd university hospital, Casablanca, Morocco.

出版信息

Ann Phys Rehabil Med. 2017 Jul;60(4):244-248. doi: 10.1016/j.rehab.2016.10.003. Epub 2016 Nov 25.

Abstract

OBJECTIVE

We aimed to evaluate the clinical outcomes after surgical repair of patellar tendon rupture (PTR) and compare the evolution of 2 types of rupture (acute and chronic) after the same rehabilitation protocol.

METHODS

This was a prospective cohort study of patients with PTR treated between January 2006 and January 2014 in the department of trauma surgery, Ibn Rochd university hospital, Casablanca.

RESULTS

We evaluated 25 patients (21 men) after a median follow-up of 75 months (range 29-120). The mean age was 34.7±8.59 years. Overall, 17 patients had acute rupture and 8 chronic rupture. Fifteen healthy volunteers (13 men) were recruited as a control group. Mean Knee Society Score (KSS) knee score was significantly higher after than before surgery (82.28±12.297 vs 20.64±7.6; P<0.0001) as was KSS function score (88.40±17.483 vs 23.40±8.98; P<0.0001). Pain measured on a visual analog scale was significantly lower after than before surgery (1.96±1.24 vs 6.60±1.26; P<0.0001). ROM and KSS knee and function scores were significantly lower on the operated than non-operated side after surgery. For both types of PTR, only knee extensor muscle strength was significantly lower on the operated than non-operated side and as compared with healthy volunteer knees.

CONCLUSIONS

Surgical repair of PTR with reinforcement and an early rehabilitation program demonstrate good results after a long follow-up. However, chronic PTR may need longer or a different rehabilitation protocol of the knee-extensor apparatus.

摘要

目的

我们旨在评估髌腱断裂(PTR)手术修复后的临床疗效,并比较相同康复方案下两种类型断裂(急性和慢性)的进展情况。

方法

这是一项对2006年1月至2014年1月在卡萨布兰卡伊本·罗什德大学医院创伤外科接受治疗的PTR患者进行的前瞻性队列研究。

结果

我们对25例患者(21例男性)进行了评估,中位随访时间为75个月(范围29 - 120个月)。平均年龄为34.7±8.59岁。总体而言,17例患者为急性断裂,8例为慢性断裂。招募了15名健康志愿者(13例男性)作为对照组。术后膝关节协会评分(KSS)的膝关节评分显著高于术前(82.28±12.297对20.64±7.6;P<0.0001),KSS功能评分也是如此(88.40±17.483对23.40±8.98;P<0.0001)。术后采用视觉模拟量表测量的疼痛明显低于术前(1.96±1.24对6.60±1.26;P<0.0001)。术后手术侧的关节活动度(ROM)以及KSS膝关节和功能评分显著低于非手术侧。对于两种类型的PTR,仅手术侧的膝关节伸肌力量显著低于非手术侧以及与健康志愿者的膝关节相比。

结论

采用加强修复和早期康复计划对PTR进行手术修复,经过长期随访显示出良好的效果。然而,慢性PTR可能需要更长时间或不同的膝关节伸肌装置康复方案。

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