Soni Sanjay, Brahmbhatt Vinit, Tolani Mohit, Soni Hemant, Pathan Sohilkhan R, Shroff Manan, Sharma Kruti B
Department of Orthopedics, Pramukhswami Medical College, Bhaikaka University, Anand, IND.
Clinical Research Services, Bhanubhai and Madhuben Patel Cardiac Center, Shree Krishna Hospital, Anand, IND.
Cureus. 2024 Feb 3;16(2):e53480. doi: 10.7759/cureus.53480. eCollection 2024 Feb.
Introduction The knee joint, an extraordinary feat of biomechanics, is prone to injuries, with the anterior cruciate ligament (ACL) often being a common victim. The intricate coordination of joint movements relies heavily on the ACL's screw-home mechanism, a crucial element for synchronizing knee movement with neighboring joints. Despite its indispensable role, the ACL is susceptible to injury, necessitating surgical intervention. While many patients experience positive outcomes following ACL reconstruction surgeries, a significant proportion face the challenge of procedure failure. The key to success lies in the healing process within the tibial and femoral bone tunnels. The post-ACL reconstruction phase introduces its own set of challenges, particularly in the context of returning to sports (RTS), underscoring the importance of reinstating neuromuscular and motor function. The trajectory of rehabilitation is influenced by factors such as graft healing, patient age, gender, pain levels, and concurrent injuries. Materials and methods This prospective observational study spanned 2.5 years, enrolling 71 patients with diagnosed ACL injuries. Arthroscopic reconstruction utilized hamstring autografts and peroneus longus autografts. A nine-month post-surgery follow-up employed the Lysholm scoring system for comprehensive evaluations. Results Over 2.5 years, 87.3% of male and 12.6% of female participants underwent arthroscopic reconstruction. Lysholm scores revealed 28.1% excellent, 45.0% good, and 26.7% fair outcomes, with no participants in the unsatisfactory range. Lysholm scores demonstrated positive outcomes, indicating the efficacy of arthroscopic reconstruction in enhancing knee function. Findings align with existing literature, emphasizing positive results from ACL reconstruction techniques and specific implants. Comparisons with related studies highlight challenges in standardized return-to-sport guidelines and underscore the need for outcome measure standardization. Conclusion The study contributes nuanced insights into ACL reconstruction outcomes, emphasizing positive functional recovery trends at the nine-month follow-up. Lysholm scores indicate favorable outcomes, supporting the procedure's effectiveness. Consideration of specific implants adds practical value. Despite limitations, this study enriches ACL reconstruction research, promoting advancements in patient care and outcomes. Ongoing research with extended follow-ups and larger cohorts will enhance understanding and refine ACL reconstruction strategies.
引言 膝关节是生物力学的非凡杰作,容易受伤,前交叉韧带(ACL)常常是常见的受害者。关节运动的复杂协调在很大程度上依赖于ACL的旋内机制,这是使膝关节运动与相邻关节同步的关键要素。尽管ACL起着不可或缺的作用,但它容易受伤,因此需要手术干预。虽然许多患者在ACL重建手术后取得了积极的效果,但仍有相当一部分患者面临手术失败的挑战。成功的关键在于胫骨和股骨骨隧道内的愈合过程。ACL重建后的阶段带来了一系列自身的挑战,特别是在恢复运动(RTS)的背景下,这凸显了恢复神经肌肉和运动功能的重要性。康复的进程受到移植物愈合、患者年龄、性别、疼痛程度和并发损伤等因素的影响。
材料与方法 这项前瞻性观察研究历时2.5年,招募了71例确诊为ACL损伤的患者。关节镜重建采用了自体腘绳肌腱移植物和自体腓骨长肌腱移植物。术后九个月的随访采用Lysholm评分系统进行全面评估。
结果 在2.5年的时间里,87.3%的男性和12.6%的女性参与者接受了关节镜重建。Lysholm评分显示,28.1%的结果为优秀,45.0%为良好,26.7%为中等,没有参与者处于不满意范围。Lysholm评分显示出积极的结果,表明关节镜重建在改善膝关节功能方面的有效性。研究结果与现有文献一致,强调了ACL重建技术和特定植入物的积极效果。与相关研究的比较突出了标准化恢复运动指南中的挑战,并强调了结果测量标准化的必要性。
结论 该研究为ACL重建结果提供了细致入微的见解,强调了在九个月随访时积极的功能恢复趋势。Lysholm评分表明结果良好,支持了该手术的有效性。对特定植入物的考虑增加了实用价值。尽管存在局限性,但这项研究丰富了ACL重建研究,促进了患者护理和结果方面的进展。正在进行的长期随访和更大样本量的研究将增进理解并完善ACL重建策略。