| Objective To compare the clinical efficacy of different treatments for anterior cruciate ligament(ACL)and medial collateral ligament(MCL)III°injury after the reconstruction of the ACL.Methods Retrospective analysis of 52 patients with MCL III°and ACL injury admitted to Dalian Medical University to the Dalian Central Hospital from June 2013 to April 2017,including 32 males and 20 females,the average age is 34.96 years old from 19 to 53 years.19 patients underwent arthroscopic reconstruction of the ACL,while repairing medial collateral ligament with two anchors simultaneously in two weeks(group A),then fixed with external fixation in 2 weeks;17 patients were treated with reconstruction of the ACL in two weeks,four extracorporeal shock wave therapies were performed after 2 weeks after surgery(group B);16 patients were treated with reconstruction of the ACL in two weeks,fixed with external fixation for 4-6weeks(group C).Patients were assessed in 3 months,6 months and 12 months after surgery,the Lysholm knee function score,the IKDC score and the knee joint ROM were recorded.Results 46 of 52 patients received long-term follow-up.2 patients in group A,2patients in group B,and 1 in group C were followed up for 3-6 months,long-term follow-up not completed.One patient in group C happened to knee stiffness 3 months after surgery.Arthroscopy and manipulation were performed under anesthesia.The follow-up rate was 88.5%,with an average of 14.2 months.Three months after operation,three groups of patients were significantly improved with the preoperative.1.The IKDC Score:At 3 months,patients in group A(51.8±3.1)and group B(49.7±3.9)were better than group C(44.5±3.4),the difference was statistically significant(P<0.05);at 6 months follow-up The A group(69.7±2.1)was better than the B group(59.8±4.3)and the C group(58.4±3.9),the difference was statistically significant(P<0.05).At the follow-up 12 months,the A group(78.9±)2.1)were better than group B(67.7±2.8)and group C(68.3±2.5),the difference was statisticallysignificant(P<0.05);2.The Lysholm Score: At 3 months,patients in group A(70.3±3.7)and group B(69.5±3.4)were better than group C(59.3±4.7),the difference was statistically significant(P<0.05);at 6 months of follow-up The A group(87.8±3.0)was better than the B group(78.7±3.4)and the C group(77.2±4.5),the difference was statistically significant(P<0.05).At the 12 months follow-up,the A group(94.8±)2.6)were better than group B(84.7±3.3)and group C(85.2±3.5),the difference was statistically significant(P<0.05).3.The ROM(°): At 3 months,patients in group A(103±5.8)were better than group B(99.1±4.8)and group C(96.2±5.0),the difference was statistically significant(P<0.05),the difference between group B and C There was no statistical significance(P>0.05).At the 6-month follow-up,group A(120.7±3.9)was superior to group B(113.6±6.8)and group C(113.0±5.6),the difference was statistically significant(P <0.05);At 12 months follow-up,group A(129.4±5.5)was better than group B(124.1±3.6)and group C(124.1±3.2),the difference was statistically significant(P<0.05).4.At 12 months,group A had 2 cases at degree?of Valgus stress testing,2 cases of anterior drawer test(+);In group B,3 cases were degree ?,2 cases of grade I for Valgus stress testing,3 cases of anterior drawer test(+);in group C,4 cases were degree ?,2 cases of grade I for Valgus stress testing,3cases of anterior drawer test(+).Conclusion For knee joint MCL III° combined with ACL injury,surgical treatment will obtain better functional scores and activity than both the conservative treatment of MCL and extracorporeal shock wave therapy,and the effect of conservative treatment of MCL injury with extracorporeal shock wave therapy is not good. |
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