Objective: To compare the clinical efficacy between medial collateral ligament (MCL) repair and MCL reconstruction in multi-ligament injury.
Methods: Thirty-one patients with MCL rupture and multi-ligament injury of knee joint were treated between August 2008 and August 2012, and the clinical data were retrospectively analyzed. Of 31 patients, 11 cases underwent MCL repair (repair group), and 20 cases underwent MCL reconstruction (reconstruction group). There was no significant difference in gender, age, body mass, injury side, injury cause, and preoperative knee Lyshlom score, International Knee Documentation Committee (IKDC) subjective score, range of motion, and medial joint opening between 2 groups (P>0.05). The postoperative knee subjective function and stability were compared between 2 groups.
Results: All incisions healed by first intention, and no postoperative complication occurred. All patients were followed up 2-4 years (mean, 3.2 years). At 2 years after operation, the IKDC subjective score, Lyshlom score, and range of motion were significantly increased in 2 groups when compared with preoperative ones (P<0.05). The range of motion of reconstruction group was significantly better than that of repair group (P<0.05). No significant difference was found in IKDC subjective score and Lyshlom score between 2 groups (P>0.05). The medial joint opening was significantly improved in 2 groups at 2 years after operation when compared with preoperative one (P<0.05), but no significant difference was found between 2 groups (P>0.05).
Conclusions: Both the MCL reconstruction and MCL repair can restore medial stability in multi-ligament injury, but MCL reconstruction is better than MCL repair in range of motion.
目的: 比较多发韧带损伤中内侧副韧带缝合与重建治疗后膝关节功能差异。.
方法: 回顾分析2008年8月-2012年8月，收治的31例合并内侧副韧带断裂的膝关节多发韧带损伤患者临床资料。其中11例行内侧副韧带缝合（缝合组），20例行内侧副韧带重建（重建组）。两组患者性别、年龄、体质量、侧别、致伤原因以及术前膝关节Lyshlom评分、国际膝关节文献委员会（IKDC）膝关节主观功能评分、膝关节活动度以及膝关节内侧间隙等一般资料比较，差异均无统计学意义（P＞0.05）。比较两组术后膝关节功能及稳定性。.
结果: 两组术后切口均Ⅰ期愈合，无手术相关并发症发生。患者术后均获随访，随访时间2～4年，平均3.2年。两组术后2年Lyshlom评分、IKDC膝关节主观功能评分及膝关节活动度均较术前显著提高，比较差异有统计学意义（P＜0.05）；重建组膝关节活动度优于缝合组，差异有统计学意义（P＜0.05）；两组Lyshlom评分及IKDC膝关节主观功能评分比较，差异无统计学意义（P＞0.05）。两组术后前、后抽屉试验及内翻应力试验均为阴性。术后2年两组膝关节内侧间隙均恢复，与术前比较差异有统计学意义（P＜0.05）；两组间比较差异无统计学意义（P＞0.05）。.
结论: 膝关节多发韧带损伤中，内侧副韧带损伤经缝合或重建治疗均能恢复膝关节内侧稳定性，但重建术后膝关节活动度优于缝合术后。.
Keywords: Joint stability; Knee; Medial collateral ligament; Multi-ligament injury.