摘要
目的探讨踝关节镜下韧带增强修复治疗慢性踝关节外侧不稳的效果。方法回顾性分析商洛市中心医院2019年10月至2022年10月诊治的慢性踝关节外侧不稳患者65例的临床资料,依据治疗方法不同分为三组,Mini-open组15例,采用关节镜辅助小切口行踝外侧韧带修复;关节镜组15例,采用全踝关节镜下韧带增强修复;非手术组35例,采用保守治疗。比较各组踝-后足评分系统(AOFAS)评分、Tegner运动水平(Tegner)评分、疼痛视觉模拟评分法(VAS)评分,恢复正常行走时间及重返运动时间。结果治疗后,三组AOFAS评分、Tegner评分、VAS评分均明显改善,差异均有统计学意义(t=6.53、7.45、6.58、6.50、7.62、6.52、6.80、7.50、6.49,均P<0.01);组间比较,三组AOFAS评分、Tegner评分、VAS评分差异均无统计学意义(均P>0.05)。关节镜组恢复正常行走时间为6.6(5.5,9.0)周,短于Mini-open组的7.4(6.0,9.0)周、非手术组的9.4(7.6,12.0)周,差异有统计学意义(H=7.98,P=0.001);关节镜组重返运动比例为80%(12/15),高于Mini-open组的66%(10/15)、非手术组的28%(10/35),差异有统计学意义(χ^(2)=30.78,P=0.025);关节镜组重返运动时间为12.1(9.5,15.0)周,短于Mini-open组的14.6(12.0,18.2)周、非手术组的16.1(13.2,19.0)周,差异有统计学意义(H=8.90,P=0.001)。结论踝关节镜下韧带增强修复治疗慢性踝关节外侧不稳,手术安全,临床疗效更佳,值得临床推广。
ObjectiveTo investigate the efficacy of arthroscopic ligament augmentation repair in the treatment of chronic lateral ankle instability.MethodsThe clinical data of 65 patients with chronic lateral ankle instability who received treatment at Shangluo Central Hospital from October 2019 to October 2022 were retrospectively analyzed.The clinical data were divided into three groups based on treatment methods:the mini-open group(n=15),in which patients underwent arthroscopy-assisted small incision lateral ligament repair;the arthroscopy group(n=15),in which patients received total ankle arthroscopic ligament augmentation repair;and the non-surgical group(n=35),in which patients were treated conservatively.The American Orthopedic Foot and Ankle Score(AOFAS)value,the Tegner Activity Scale(TAS)score,Visual Analog Scale(VAS)score,the time to achieve full weight-bearing,and the time to return to sports were compared among all groups.ResultsAfter treatment,AOFAS value and the TAS score increased in all three groups compared with pre-treatment levels,while the VAS value decreased in all groups.All differences were statistically significant(t=6.53,7.45,6.58,6.50,7.62,6.52,6.80,7.50,6.49,all P<0.01).There were no significant differences in AOFAS value,TAS score,and VAS score among the three groups(all P>0.05).The time to achieve full weight-bearing in the arthroscopy group was 6.6(5.5,9.0)weeks,which was shorter than the 7.4(6.0,9.0)weeks in the mini-open group and the 9.4(7.6,12.0)weeks in the non-surgical group.These differences were statistically significant(H=7.98,P=0.001).The proportion of patients returning to sports in the arthroscopy group was 80%(12/15),which was higher than the 66%(10/15)in the mini-open group and the 28%(10/35)in the non-surgical group.These differences were statistically significant(χ²=30.78,P=0.025).The time to return to sports in the arthroscopy group was 12.1(9.5,15.0)weeks,which was shorter than the 14.6(12.0,18.2)weeks in the mini-open group and the 16.1(13.2,19.0)weeks in the non-surgical group.These differences were statistically significant(H=8.90,P=0.001).ConclusionsAnkle arthroscopic ligament augmentation repair for the treatment of chronic lateral ankle instability is safe and shows better clinical efficacy,making it a viable option for clinical practice.
作者
王琦
柯贤鹏
王立松
王鹏斌
牛英
Wang Qi;Ke Xianpeng;Wang Lisong;Wang Pengbin;Niu Ying(Department of Sports Medicine and Joint Surgery,Shangluo Central Hospital,Shangluo 726000,Shaanxi Province,China)
出处
《中国基层医药》
2025年第7期1034-1038,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
陕西省商洛市科技计划(2022-Y-0024)。
关键词
踝关节
关节镜检查
外侧韧带
踝
关节不稳定性
修复外科手术
Ankle joint
Arthroscopy
Lateral ligament,ankle
Joint instability
Reconstructive surgical procedures
