Medical School of Chinese PLA, Beijing, China.
Beijing Chaoyang Integrative Medicine Emergency Medical Center, Beijing, China.
J Clin Lab Anal. 2020 Dec;34(12):e23543. doi: 10.1002/jcla.23543. Epub 2020 Aug 26.
This study was performed to compare the clinical efficacies of anterior cruciate ligament (ACL) reconstruction with autologous ligament grafting at different time points.
Eighty-five patients with ACL were categorized into two groups: Group A (GA, n = 45), who underwent early-stage (≤3 weeks) surgery, and Group B (GB, n = 40), who underwent advanced-stage (>3 weeks) surgery. Perioperative conditions, knee joint functions, activity and stability before and at 6 months postoperatively, changes in quality of life (QOL), good and excellent rates of knee joint functions, and incidence of complications were compared between the two groups.
In both groups, there was an increase in the International Knee Documentation Committee (IKDC) score, Lysholm score, and QOL and a decrease in the knee joint angle flexion limitation, angle of spread limitation, positive rates in the anterior drawer test (ADT), and Lachman test score (P < .05) after surgery. At 6 months postoperatively, the IKDC score, Lysholm score, and QOL were higher in GA than in GB (P < .05). The good and excellent rates of knee joint functions were higher in GA than in GB (93.33% vs. 77.50%) (P < .05).
Anterior cruciate ligament reconstruction with autologous ligament grafting can achieve good effects whether performed in the early or advanced stage; however, the improvements in patients' knee joint functions and QOL are better in the early stage. Therefore, early ACL reconstruction with autologous ligament grafting is suggested.
本研究旨在比较不同时间点行自体韧带移植重建前交叉韧带(ACL)的临床疗效。
85 例 ACL 患者分为两组:A 组(GA,n=45)行早期(≤3 周)手术,B 组(GB,n=40)行晚期(>3 周)手术。比较两组围手术期情况、膝关节功能、术后 6 个月时膝关节活动度和稳定性、生活质量(QOL)变化、膝关节功能优良率和并发症发生率。
两组术后国际膝关节文献委员会(IKDC)评分、Lysholm 评分和 QOL 均升高,膝关节屈曲受限角度、关节间隙扩大受限角度、前抽屉试验(ADT)阳性率和 Lachman 试验评分均降低(P<0.05)。术后 6 个月,GA 组 IKDC 评分、Lysholm 评分和 QOL 均高于 GB 组(P<0.05)。GA 组膝关节功能优良率高于 GB 组(93.33% vs. 77.50%)(P<0.05)。
自体韧带移植重建 ACL 无论在早期还是晚期进行,均可取得良好效果,但早期患者膝关节功能和 QOL 改善更好。因此,建议早期行 ACL 自体韧带移植重建。