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前交叉韧带重建术后关节纤维化

Arthrofibrosis Following Anterior Cruciate Ligament Reconstruction.

作者信息

Rushdi I, Sharifudin S, Shukur A

机构信息

Department of Orthopaedics, Hospital Teluk Intan, Teluk Intan, Malaysia.

出版信息

Malays Orthop J. 2019 Nov;13(3):34-38. doi: 10.5704/MOJ.1911.006.

Abstract

Anterior cruciate ligament (ACL) tear is a frequent injury and its reconstruction is among the most commonly performed orthopaedic surgical procedures. ACL reconstruction generally yields good results. However, its recovery can be hampered by the development of postoperative complications. The aim of this study was to review complications following arthroscopic ACL reconstruction done in Hospital Raja Permaisuri Bainun, Ipoh and Hospital Teluk Intan, Perak with the emphasis on arthrofibrosis. Arthrofibrosis is defined as a loss of 15 degrees extension or more, with or without flexion loss compared to the contralateral knee. The study is based on a series of retrospective cases, on which medical records of 200 patients who underwent ACL reconstruction surgeries between March 2007 and December 2014 were reviewed. Follow-up treatment records were available for 166 patients (83%). The data was analysed to identify the risk factors for developing complications with an emphasis on arthrofibrosis. Eight patients (5%) developed arthrofibrosis in the post-operative period. Early surgical intervention, preoperative limited range of motion and female gender are the risk factors correlate with arthrofibrosis. However, the type of graft used and meniscal procedure do not have a significant correlation with the development of arthrofibrosis. Other complications encountered are local infections, hypertrophic scar and chronic regional pain syndromes. The 5% incidence of arthrofibrosis following an ACL reconstruction in our centres can be reduced with proper preventive measures which include thorough preoperative evaluation, proper patient selection, restoration of ROM prior to surgery and proper timing of surgery.

摘要

前交叉韧带(ACL)撕裂是一种常见损伤,其重建是最常进行的骨科手术之一。ACL重建通常能取得良好效果。然而,术后并发症的发生可能会阻碍其恢复。本研究的目的是回顾在怡保苏丹后妃拜农医院和霹雳州直落英丹医院进行的关节镜下ACL重建术后的并发症,重点关注关节纤维化。关节纤维化的定义为与对侧膝关节相比,伸直丧失15度或更多,无论是否伴有屈曲丧失。本研究基于一系列回顾性病例,对2007年3月至2014年12月期间接受ACL重建手术的200例患者的病历进行了回顾。166例患者(83%)有随访治疗记录。对数据进行分析以确定发生并发症的风险因素,重点是关节纤维化。8例患者(5%)在术后出现关节纤维化。早期手术干预、术前活动范围受限和女性性别是与关节纤维化相关的风险因素。然而,所使用的移植物类型和半月板手术与关节纤维化的发生没有显著相关性。其他遇到的并发症包括局部感染、肥厚性瘢痕和慢性区域疼痛综合征。通过适当的预防措施,包括全面的术前评估、合适的患者选择、术前恢复活动范围和合适的手术时机,可以降低我们中心ACL重建术后5%的关节纤维化发生率。

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