Wei Yu, Yun Xing, Liu Yang, Wei Min
Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, P.R.China.
.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Mar 15;35(3):337-342. doi: 10.7507/1002-1892.202008127.
To investigate the effectiveness of partial anterior cruciate ligament (ACL) suture repair with wide awake local anesthesia no tourniquet (WALANT) technique.
Between July 2017 and July 2019, 18 patients with partial ACL injury were admitted. There were 10 males and 8 females, with an average age of 40.5 years (range, 22-57 years). There were 5 cases on the left knee and 13 cases on the right knee. Forteen cases had a clear history of trauma or sports injury, and 4 cases had no obvious cause. The time from injury to operation was 1-6 months (median, 3 months). Partial ligament was sutured using WALANT technique under arthroscopy. The operation time, total hospital stay, and postoperative hospital stay were recorded. Lachman test and anterior drawer test were performed to evaluate the knee joint stability after treatment, and Lysholm and International Knee Documentation Committee (IKDC) scores were used to evaluate the knee function. Five-point Likert scaling were used to evaluate postoperative patient satisfaction.
The operation time was 30-100 minutes (mean, 64.2 minutes). The total hospital stay was 2-12 days (mean, 4.5 days). Postoperative hospital stay was 1-4 days (mean, 1.8 days). All incisions healed by first intention after operation, and no surgery-related complications occurred. All patients were followed up 12-36 months (mean, 19.1 months). Lachman test and anterior drawer test were negative after operation. Lysholm score and IKDC score at 6 and 12 months after operation were significantly higher than those before operation, and at 12 months after operation were higher than those at 6 months after operation, the differences were significant ( <0.05). At last follow-up, according to five-point Likert scaling of patient satisfaction, 7 cases were very satisfied, 10 cases were relatively satisfied, and 1 case was general. The total patient satisfaction rate was 94.4% (17/18). MRI scan showed the good ligament tension.
Using WALANT technique to repair partial ACL injuries under arthroscopy can retain the patient's own ligament tissue to the maximum extent and achieve satisfactory short-term effectiveness.
探讨在清醒局部麻醉无止血带（WALANT）技术下进行部分前交叉韧带（ACL）缝合修复的有效性。
2017年7月至2019年7月，收治18例部分ACL损伤患者。其中男性10例，女性8例，平均年龄40.5岁（范围22 - 57岁）。左膝5例，右膝13例。14例有明确的外伤或运动损伤史，4例无明显诱因。受伤至手术时间为1 - 6个月（中位数3个月）。在关节镜下采用WALANT技术对部分韧带进行缝合。记录手术时间、总住院时间和术后住院时间。治疗后进行Lachman试验和前抽屉试验以评估膝关节稳定性，采用Lysholm评分和国际膝关节文献委员会（IKDC）评分评估膝关节功能。采用五点李克特量表评估患者术后满意度。
手术时间为30 - 100分钟（平均64.2分钟）。总住院时间为2 - 12天（平均4.5天）。术后住院时间为1 - 4天（平均1.8天）。术后所有切口均一期愈合，未发生与手术相关的并发症。所有患者均获随访12 - 36个月（平均19.1个月）。术后Lachman试验和前抽屉试验均为阴性。术后6个月和12个月的Lysholm评分和IKDC评分均显著高于术前，且术后12个月高于术后6个月，差异有统计学意义（<0.05）。末次随访时，根据患者满意度的五点李克特量表，7例非常满意，10例比较满意，1例一般。患者总满意度为94.4%（17/18）。MRI扫描显示韧带张力良好。
在关节镜下采用WALANT技术修复部分ACL损伤可最大程度保留患者自身韧带组织，并取得满意的短期疗效。
