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低需求、非运动员患者采用家庭康复方案后关节镜下前交叉韧带重建的结果

The Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction in Low-Demand, Non-athletic Patients Following a Home-Based Rehabilitation Protocol.

作者信息

Singh Satyam, Ul Haq Rehan, Arora Jitesh

机构信息

Orthopaedics, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IND.

Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND.

出版信息

Cureus. 2023 Jun 1;15(6):e39851. doi: 10.7759/cureus.39851. eCollection 2023 Jun.

DOI:10.7759/cureus.39851
PMID:37404419
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10314972/
Abstract

BACKGROUND

Arthroscopic anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure. Most of the literature is on high-demand athletic patients, with little information about the outcomes of low-demand patients. Therefore, we aim to assess the outcomes of non-athletic patients following home-based rehabilitation.

METHODS

An observational cross-sectional comparative study was conducted with 30 non-athletic adults with ACL injuries whose pre-injury Tegner activity level was four or less. After six months of reconstruction, patients were assessed for functional outcomes using the Tegner activity level, Lysholm score, International Knee Documentation Committee (IKDC) score, and ACL quality of life (QOL) score. Functional performance was assessed by the carioca test, one-leg hop test, and shuttle test. Functional outcome and performance were compared with an age, sex, and activity level-matched group. Knee stability was assessed by Lachman, anterior drawer, and pivot shift.

RESULTS

All patients returned to their pre-injury Tegner activity level. A statistically significant difference was seen in the Lysholm score, IKDC score, ACL QOL score, carioca test, shuttle test, and one leg hop test (p= <0.001 in each); >5mm of translation of the tibia in the Lachman test was seen in three patients, whereas one patient had >5 mm of translation in the anterior drawer test but pivot shift was absent in all.

CONCLUSION

We found that all patients returned to their pre-injury Tegner activity level. Most patients had improved knee stability; however, functional outcomes and performance were lower compared to the control group. Therefore, arthroscopic ACL reconstruction is a reasonable treatment option for non-athletic, low-demand patients to get back to their pre-injury functional activity level.

摘要

背景

关节镜下前交叉韧带(ACL)重建是一种常见的骨科手术。大多数文献关注的是高需求的运动员患者,关于低需求患者的手术结果信息较少。因此,我们旨在评估非运动员患者居家康复后的手术结果。

方法

对30名ACL损伤的非运动员成年人进行了一项观察性横断面比较研究,这些患者受伤前的Tegner活动水平为4或更低。重建术后6个月,使用Tegner活动水平、Lysholm评分、国际膝关节文献委员会(IKDC)评分和ACL生活质量(QOL)评分对患者的功能结果进行评估。通过 carioca 试验、单腿跳试验和穿梭试验评估功能表现。将功能结果和表现与年龄、性别和活动水平匹配的组进行比较。通过Lachman试验、前抽屉试验和轴移试验评估膝关节稳定性。

结果

所有患者均恢复到受伤前的Tegner活动水平。Lysholm评分、IKDC评分、ACL QOL评分、carioca试验、穿梭试验和单腿跳试验均有统计学显著差异(每项p = <0.001);3例患者在Lachman试验中胫骨平移>5mm,而1例患者在前抽屉试验中平移>5mm,但所有患者均无轴移。

结论

我们发现所有患者均恢复到受伤前的Tegner活动水平。大多数患者膝关节稳定性有所改善;然而,与对照组相比,功能结果和表现较低。因此,关节镜下ACL重建对于非运动员、低需求患者恢复到受伤前的功能活动水平是一种合理的治疗选择。

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