跳马训练所致膝前交叉韧带损伤与临床转归分析△（开放获取）

(Open Access) Analysis of cause and clinical outcome of knee anterior cruciate ligament injury by vault training

摘要:

[目的] 探讨跳马训练致膝前交叉韧带损伤（anterior cruciate ligament injury, ACLI） 的风险因素和术后复训效果。[方法] 回顾性分析2019 年10 月1 日—2022 年10 月31 日联勤保障部队第九四〇医院收治的因跳马训练致ACLI 的伤员，比较其一般信息、损伤情况、随访及复训等资料。[结果] 纳入356 例因跳马训练致膝关节损伤伤员，其中跳马一训练致伤117例，跳马二训练致伤158 例，跳马三训练致伤81 例。与术前相比，术后不同年龄[＜25 岁组, (4.2±1.7), (0.3±0.8), P＜0.001; ≥25岁组, (4.4±1.5), (0.4±0.8), P＜0.001]、不同职级[士兵组, (4.3±1.6), (0.3±0.8), P＜0.001; 军官组, (4.5±1.4), (0.4±1.0), P＜0.001]、不同伤后时间[急性期组, (6.0±1.3), (0.6±1.4), P＜0.001; 亚急性期, (4.9±0.8) (0.4±0.6), P＜0.001; 慢性期组, (3.2±1.1) (0.3±0.8), P＜0.001]VAS 评分均显著改善。与术前相比，术后不同年龄[＜25 岁组, (52.8±4.8), (89.7±5.5); P＜0.001; ≥25 岁组, (53.2±4.1), (89.5±5.5), P＜0.001]、不同职级[士兵组, (53.1±4.4), (89.5±5.3); P＜0.001; 军官组, (52.9±4.5), (89.9±6.2), P＜0.001]、不同伤后时间[急性期组,(53.5±4.0), (90.2±5.6), P＜0.001; 亚急性期, (52.5±4.1), (89.3±5.8), P＜0.001; 慢性期组, (53.1±4.7), (89.5±5.2), P＜0.001] Lysholm 评分均显著改善。与术前相比，术后不同年龄[＜25 岁组, (92.0±13.4)°, (132.0±6.0)°, P＜0.001; ≥25 岁组, (90.1±11.2)°, (131.9±5.7)°, P＜0.001]、不同职级[士兵组, (90.3±11.8)°, (132.1±5.8)°; P＜0.001; 军官组, (94.0±13.4)°, (131.2±5.7)°, P＜0.001]、不同伤后时间[急性期组, (92.4±13.1)°, (132.3±6.5)°, P＜0.001; 亚急性期, (90.4±12.8)°, (131.5±5.5)°, P＜0.001; 慢性期组, (90.7±11.3)°, (132.1±5.6)°, P＜0.001] ROM 均显著改善。不同年龄段、不同职级、伤后不同时间段、不同致伤科目间在主要评估指标上差异无统计学意义（P＞0.05）。随访期间356 例伤员中达到复训标准99 例（27.8%），平均需16 个月恢复至复训状态。[结论] 跳马训练是ACLI的重要致病因素， ACLR 术后患者的膝关节功能恢复良好，但伤后恢复周期长、复训率低。

Abstract:

[Objective] To investigate the risk factors of anterior cruciate ligament injury (ACLI) caused by vault training and the effectof postoperative rehabilitation training. [Methods] A retrospective study was done on the patients who underwent arthroscopic ACL recon-struction for ACLI due to vault training in The 940th Hospital, Joint Logistics Support Force of PLA from October 1, 2019 to October 31,2022. The data regarding their general information, injury status, follow-up and re-training data were compared. [Results] A total of 356patients with knee joint injury caused by vault training were included into this study, including 117 patients with knee joint injury causedby vault training I, 158 patients with knee joint injury caused by vault training II and 81 patients with knee joint injury caused by vaulttraining III. The VAS score, Lysholm score and ROM were significantly improved in the patients after operation compared with those preop-eratively (P＜0.05). However, there were no significant differences in the main evaluation parameters, including different age, different mili-tary ranks, different time periods after injury and different injury subjects (P＞0.05). During the follow-up, 99 (27.8%) of the 356 patientsreached the standard of re-training, and it took an average of 16 months to recover to the state of re-training. [Conclusion] Vault training is an important cause of ACLI. Although the patients are well recovered in clinic state, the recovery period after injury is long and the re-train-ing rate is low.