摘要
Abstract
Objective:This study aims to assess the efficacy and outcomes of arthroscopic autogenous tendon anatomical reconstruction surgery and allogeneic tendon anatomical reconstruction surgery in enhancing ankle joint function in patients with ankle ligament injuries.Methods:A total of 210 patients with ankle ligament injuries admitted to our hospital from June 2020 to June 2023 were selected and divided into two groups:an experimental group undergoing autogenous tendon anatomical reconstruction surgery(n=106)and a control group undergoing allogeneic tendon anatomical reconstruction surgery(n=104)based on patient selection.After applying the propensity score matching(PSM)method,55 patients were matched in a 1∶1 ratio in each group.We compared the clinical data of two groups of patients,measured and statistically analyzed six imaging grade 0,grade Ⅰ,grade Ⅱ,and grade Ⅲgrading parameters and functional scores of patients,analyzed their correlation,and established a generalized estimation equation(GEE)model for the functional score indicators of patients before and after surgery under different surgical methods.Results:Both groups of patients showed improvement in ligament imaging grading and functional scores after treatment.After treatment,the grading of the medial and lateral collateral ligaments in the experimental group increased from average grade Ⅲ to grade 0,and the AOFAS score increased from 58.96 to 90.71,both significantly better than the control group(P＜0.05).After treatment,the experimental group showed better grades and functional scores in the lateral and medial collateral ligaments than the control group(all P＜0.05).There was a correlation(P＜0.05)between the preoperative and postoperative grading indicators of the anterior talofibular ligament,calcaneofibular ligament,posterior talofibular ligament,tibionavicular ligament,tibio-calcaneal ligament,and anterior-posterior tibial-talar ligament.All imaging parameters were correlated with AOFAS,Tegner,VAS,Mcd,and Msd scores(P＜0.05).There was a correlation(P＜0.05)between the preoperative and postoperative differences in various imaging parameters and the improvement rate of five functional scoring indicators,with the strongest correlation observed between the anterior and posterior tibial ligaments.The GEE model indicated that the improvement of functional scoring indicators in the experimental group was superior to that in the control group.The increase in the AOFASscore in the control group was 0.025 lower than that in the experimental group.Additionally,the increase in the Tegner score was 1.258 lower than that of the experimental group.Furthermore,VAS,Mcd,and Msd decreased by 2.532,2.288,and 1.957,respectively.Conclusion:Arthroscopic autogenous tendon anatomical reconstruction surgery is significantly better than allogeneic tendon anatomical reconstruction surgery in improving ligament grading and functional scores in patients with ankle ligament injury.The postoperative grading and functional scores of the medial and lateral collateral ligaments are significantly improved(P＜0.05).关键词
关节镜/自体肌腱解剖重建术/踝关节韧带损伤/关节功能恢复Key words
arthroscopic/autologous tendon anatomical reconstruction surgery/ankle ligament injury/joint function recovery分类
临床医学
