【作者】 马燕红； 程安龙； 王亚泉；

【Author】 Ma Yan Hong, Cheng An Long, Wang Ya Quan, et al.

【机构】 上海市第六人民医院康复医学科；

【摘要】 目的 观察自体多股半腱肌半膜肌(STG)重建膝前交叉韧带术后早期康复的安全性和对患膝功能水平的影响.方法 单侧自体多股半腱肌半膜肌膝前交叉韧带重建术48例,其中31例术后进行正规康复训练4～6月即康复组,平均年龄29.15±16.74,17例术后未进行正规康复治疗作对照组,平均年龄28.76±19.59.比较两组患者术后6月的关节活动度、肌力、Lysholm评分及关节稳定性.术后康复包括:术后使用膝可调支具,术后0～2周局部消肿、股四头肌内侧头电刺激、股肉等长收缩、髌骨内推、关节活动度被动训练等,目标是膝屈曲≥90°,双拐步行.术后3～6周关节活动度训练,单拐步行,闭链肌力训练,固定自行车、本体感觉训练,目标是恢复全部关节活动范围,逐渐恢复正常步态.6周～4月主要是加强下肢肌力训练,包括 绳肌、股四头肌抗阻训练,开始跑步,目标是增强下肢活动能力,提高肌力和耐力,增强使用患肢的自信.4～6月进一步增强下肢肌力和耐力,恢复正常运动.结果 术后6月康复组与对照组伸展迟滞分别是2.63±2.50和4.15±2.65,屈曲度减少分别是4.15±2.95和5.01±2.41,P<0.05.Cybex肌力测试康复组与对照组伸肌(患肢/健肢)71.57±6.82%vs62.6±27.54%,屈肌(患肢/健肢)90.01±8.75vs75.29±8.38%,P<0.001.康复组Lysholm评分90.1±5.15,对照组82.4±7.56,P<0.05.关节稳定性检查,术后6月两组患膝Lanchman和Pivot shift检查均阴性.结论 前交叉韧带术后早期康复能促进患膝AROM、患肢肌力和功能水平的恢复,术后6月随访临床膝关节稳定检查均阴性表明,自体多股STG重建膝前交叉韧带术后早期康复是安全的.更多还原

【Abstract】 Objective To evaluate the effects of early rehabilitation on anterior cruciate ligament reconstruction with STG. Method 48 cases were divided into two groups. Group I involves in 31 patients who underwent early rehabilitation for 4 - 6month post - operation. Group II involved in 17 patients as control. The knee range of motion, Lysholm score and knee laxity were evaluated. The muscle strength of knee extension and flexion was tested by Cybex II . Results The extension and flexion deficit was significantly smaller in group 1 ,2. 63 + 2. 50 vs 4. 15 + 2. 65, 4. 15 + 2. 95 vs 5. 01 + 2. 41, respectively. Patients in group I achieved better muscle strength than patients in group II , and Lysholm score was higher in group I .All patients had negative Lanchman and Pivot shift test. Conclusion The Results suggest that early rehabilitation would improve the patient’s function after and it is safety for reconstruction using STG.更多还原