摘要
目的介绍采用四股半腱肌肌腱和缝线钢板重建前十字韧带后的康复训练方法,总结其近期效果。方法对51例陈旧性前十字韧带损伤的患者采用四股半腱肌肌腱和缝线钢板进行重建,术后进行1年以上系统的康复指导。按照Lysholm膝关节功能评分标准,术前膝关节功能评分为(56.7±7.4)分。康复内容包括支具制动及负重计划、肌力、活动度、本体感受器训练和肌肉牵张训练等方面。通过膝关节稳定性、肌力、活动度、步态分析,以及膝关节功能评分,总结这种训练方法的可行性和效果。结果术后3个月,膝关节的活动度均恢复正常。术后1年,患肢的股四头肌-绳肌峰力矩比值超过正常侧的80%。KT-1000检查结果显示,术后6、12个月,患侧膝关节前向松弛度大于健侧的比例分别为11.76%(6/51)和10.41%(5/48),但松弛度差异均在4mm以内,其余患者患侧膝关节前向松弛度与健侧相同或者小于健侧。术后1年,95.83%的患者都能够恢复正常步态,膝关节功能评分为(97.8±1.2)分。统计学分析显示,术后与术前评分相比差异有显著性意义。结论对于不合并严重内、外侧韧带复合结构损伤的陈旧性前十字韧带损伤,在采用四股半腱肌肌腱和缝线钢板进行重建后,采用该方法进行康复训练是切实可行且有效的。
Objective To introduce the rehabilitation methods after arthroscopic reconstruction of the anterior cruciate ligament with quadrupled stranded semitendinosus tendon and suture plate, and to evaluate the clinical outcome. Methods Fifty one cases of the anterior cruciate ligament ruptures were reconstructed arthroscopically with quadrupled stranded semitendinosus tendon and suture plate. The patients were instructed postoperatively for rehabilitation for more than one year. According to Lysholm knee score scale, the knee function score were 56.7±7.4 before surgery. The rehabilitation program included brace immobilization and weight bearing, exercises for muscle strength, range of motion, proprioception, and muscle extension. Through analysis of stability, muscle strength, range of motion and gaits, and through knee scale score evaluation, the applicability and effectiveness of this rehabilitation program were studied. Results The ranges of motion of the operated knee were regained in all cases three months after surgery. The quadriceps/hamstrings peak torque ratio reached approximately 80 percent of the uninjured leg one year after operation. KT 1000 examination showed that the anterior laxity of the operated knee was greater than the normal knee in 11.76 percent and in 10.41 percent of the patients respectively, six and twelve months postoperatively, but the side to side differences were less than 4 mm. In the other patients, the anterior laxity of the operated knee was equal to or less than that of the normal knee. One year after operation, 95.83 percent of the patients regain normal gaits, and the total knee score were 97.8±1.2 according to Lysholm knee score scale. Statistically the difference between the Lysholm score before and one year after operation has prominent significance. Conclusion For the patients after ACL reconstruction, this rehabilitation procedure was practical and effective for the functional restoration of the injured knee as well as the injured leg.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第2期95-99,共5页
Chinese Journal of Orthopaedics
