关节镜下全内重建不同时期前交叉韧带损伤的疗效分析
1.扬州大学医学院，江苏 扬州 225009；
2.丹阳市人民医院，江苏 丹阳 212300；
3.苏北人民医院，江苏 扬州 225001收稿日期: 2025-02-21
修回日期: 2025-11-25
录用日期: 2026-03-18
网络出版日期: 2026-03-19
基金资助
扬州市重点实验培育项目（YZ2021143）
The Clinical Effect of Arthroscopic All-Inside Reconstruction of Anterior Cruciate Ligament Injury at Different Stages
Received date: 2025-02-21
Revised date: 2025-11-25
Accepted date: 2026-03-18
Online published: 2026-03-19
目的：比较前交叉韧带急性损伤患者在膝关节镜全内技术下，选择不同手术时机，采用自体肌腱行前交叉韧带重建术后的临床疗效。方法：回顾性分析2021年9月至2023年6月丹阳市人民医院收治的67例前交叉韧带急性损伤患者的病历资料。患者均接受膝关节镜下全内重建前交叉韧带术，根据不同手术时机分为早期组35例（受伤后至手术时间28 d内），晚期组32例（受伤后至手术时间≥28 d），均以自体半腱肌和股薄肌编织为前交叉韧带替代物，术后随访6个月。比较两组患者术前、术后膝关节活动度、膝关节稳定性及手术并发症。评估标准：Lysholm膝关节评分、国际膝关节文献委员会膝关节评估表（IKDC）、膝关节屈伸活动度范围（ROM）、疼痛视觉模拟（VAS）评分。结果：术前两组患者IKDC、膝关节Lysholm评估量表、疼痛VAS评分比较，差异均无统计学意义（P>0.05）。术后6个月，早期组Lyshalm评分、IKPC评分明显高于晚期组（P<0.05）。术前两组患者膝关节活动度比较，差异无统计学意义（P>0.05），术后6个月时，早期组膝关节活动度数明显大于晚期组（P<0.05）。术前两组患者疼痛VAS评分比较，差异无统计学意义（P>0.05），术后6个月与晚期组比较，早期组疼痛评分明显更低（P<0.05）。结论：采用自体肌腱行关节镜下全内重建前交叉韧带，早期（≤28 d）手术更加有利于术后膝关节活动度及稳定性的改善，更加有利于下肢功能恢复，可以获得更佳的临床疗效。
毛华杰
,
王永祥
,
江起庭
.
关节镜下全内重建不同时期前交叉韧带损伤的疗效分析
Objective： To compare the clinical effect of anterior cruciate ligament all-inside reconstruction in patients with acute anterior cruciate ligament injury by using autologous tendon under knee arthroscopy and choosing different surgical timings.Methods： This study retrospectively analyzed the clinical data of 67 patients with acute anterior cruciate ligament injury admitted to the People's Hospital of Danyang from September 2021 to June 2023. All of these patients underwent arthroscopic anterior cruciate ligament all-inside reconstruction and were divided into the early group （35 cases， within 28 d from injury to surgery） and the late group （32 cases， the time from injury to surgery ≥28 d） according to different surgical timings. The patients all used autologous semitendinosus muscle and gracilis muscle braid as anterior cruciate ligament substitutes， and were followed up for 6 months after the operation. The range of motion of the knee joint， stability of the knee joint before and after the operation and surgical complications of the two groups of patients were compared. Evaluation criteria： Lysholm knee score （LKSS）， the international knee documentation committee knee evaluation form （IKDC）， knee extension range of motion （ROM） and visual analogue score （VAS） for pain.Results： Before the operation， there were no statistically significant differences in IKDC， LKSS， and the VAS score for pain between the two groups （P > 0.05）. 6 months after operation， compared with the late group， the above scores of the early group were significantly higher （P < 0.05）. There was no statistically significant difference in the range of motion of the knee joint between the two groups before the operation （P > 0.05）. 6 months after the operation， the range of motion of the knee joint in the early group was significantly greater than that in the late group （P < 0.05）. There was no statistically significant difference in the VAS score for pain between the two groups before the operation （P > 0.05）. 6 months after the operation， compared with the late group， the pain score of the early group was significantly lower （P < 0.05）.Conclusion： Use arthroscopic all-inside reconstruction of anterior cruciate ligament with autologous tendon， early surgery （≤ 28 days） is more conducive to the improvement of postoperative knee joint mobility and stability， is more conducive to the recovery of lower limb function and can obtain better clinical efficacy.
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