To Observe The Feasibility And Clinical Efficacy Of One-stage Arthroscopic Reconstruction Of The Ligament Injury Of The Knee Joint

Purpose:To observe the feasibility and clinical efficacy of one-stage arthroscopic reconstruction of the ligament injury of the knee joint.Methods: From October 2016 to November 2017,30 patients with unilateral knee ligament injury were treated in Hospital.doctors gave arthroscopy the next stage of ligament repair and reconstruction.There were 20 males and 10 females;12 of the left knee joints and 18 of the right knee joints;the age range of injuries was 18-55 years old,and the average age was 35.35±2.31 years old.Causes of injury: 17 cases of traffic accidents caused by car accidents,4 cases of falling injuries and 9 cases of acute sports injuries.After admission,the senior Orthopaedic Physician conducted a systematic examination of the system,improved the preoperative related auxiliary examination,and initially identified the injury.Immediately give the patient limb brake,raise the affected limb,the ice around the knee joint to reduce swelling treatment,oral combined intravenous multi-channel multi-mode analgesia,anti-tumor drug intravenous drip swelling and other symptomatic support treatment,specialist sports medicine rehabilitation physician guidance The patient actively performs rehabilitation exercises such as sputum pump and quadriceps before surgery to promote blood circulation of the lower limbs,reduce the degree of swelling of the lower limbs,create favorable conditions for surgery,prevent muscle atrophy of lower limbs,and accelerate the recovery of postoperative limb function.The time from injury to surgery was 7.0-14.0days,with an average of 10.12 ± 1.35 days.All patients underwent X-ray examination of the knee joint,CT scan of the knee joint + reconstruction examination to determine whether there was fracture injury,improve the lower extremity vascular ultrasound to exclude the important vascular injury of the lower extremity,improve the MRI of the knee joint and evaluate the combined physical examination.Knee ligament injury,including 6 cases of anterior cruciate ligament(ACL),posterior cruciate ligament(PCL)and medial collateral ligament(MCL)injury,4 cases of ACL,PCL And posterolateral corner(PLC)injury,8 cases of ACL,PCL injury,6 cases of ACL,MCL injury,6 cases of PCL,MCL injury.Reconstruct ACL,PCL,PLC and repair MCL in the next stage of arthroscopy.Regular follow-up visits to the outpatient clinic,regular review of the lateral X-ray of the knee joint,CT scan of the knee joint + reconstruction to determine whether the ligament fixation is abnormal,whether the bone is enlarged or not,and the joint activity and stability check at regular follow-up,IKDC rating,Lysholm knee function score,etc.Active and passive functional exercise of the affected limbs was performed early in the postoperative period.After the operation,the disc-type brace with adjustable mobility was used to fix the position(adjustment angle was 0°),and the pain was relieved on the first day after the operation.Functional training of lowerextremity sputum pump,quadriceps muscle,2 weeks began to support the knee joint training without the weight-bearing flexion and extension in the assisted physician.After 6 weeks,the flexion and extension knee joint degree gradually reached 90° and above,and the knee flexion and extension step after 8 weeks.Up to 120° and above,after 3 months,under the protection of the brace,the daily activities can be carried out step by step,and during the rehabilitation period,high-explosive sports activities are prohibited.Results: All patients had no complications such as infection of the incision and deep vein thrombosis of the lower extremity.All patients were followed up for 12-24 months,with an average follow-up of 15.60 ± 2.65 months.At the last follow-up,the stability of the knee joint was significantly improved compared with preoperative.The anterior and posterior drawer tests of the knee joint,the Lachman test,and the 30% flexion and valgus stress test were significantly lower than those before surgery.The active knee joint mobility increased from 47.23±10.11°(15°-90°)to 121.83±5.88°(100°-135°),and the difference was statistically significant(P < 0.05).At the time of admission,the IKDC scores of the International Knee Documentation Committee were significantly abnormal(Grade D).At the last follow-up,the IKDC score was 20(normal)(A grade),8 normal(B grade),and abnormal(Grade C).example.At the last follow-up,the Lysholm knee function score increased from 30.93±6.96(0-60)points to 85.00±5.03(70-100)points,and the difference was statistically significant(P < 0.05).Conclusion: Arthroscopic reconstruction of ACL,PCL,PLC and repair of MCL is a safe and effective method for the treatment of knee ligament injury.It can significantly improve knee joint stability,improve mobility and effectively restore knee joint motor function.