| OBJECTIVE: 1)To calculate the exact position of the theoretical isometric points of the anterior cruciate ligament(ACL);2)To find out the position of the ACL isometric points according to the first part of the ACL reconstruction,and to estimate the effect of the two methods on the isometric points of the ACL by comparing the effects of different drilling methods of the femoral tunnel;3)To compare the prognosis of the patients after ACL reconstruction with different rehabilitation programmes and to evaluate them,so as to find out the best rehabilitation scheme for the patients after ACL reconstruction.METHODS: 1)30 patients with ACL injury were admitted to our hospital from June2018 to February 2019.All patients underwent three-dimensional CT reconstruction of the knee joint at the time of admission.The original CT data were used to establish the knee joint model,and 3D printing.The anterior cruciate ligament(ACL)of the medial surface of the lateral femoral condyle was reconstructed by drilling the femoral tunnel and the tibial tunnel,and the ACL was simulated by high-strength suture,fix the model on the CPM machine,fix the pull-wire displacement sensor on one side of the CPM machine,set the CPM machine to pause every 10 degrees and record the sensor readings until 120 degrees.2)The second phase study included 50 patients who were diagnosed as anterior cruciate ligament(ACL)injury in our ward from March 2019 to October 2019.The patients were divided into two groups on average.All patients filled in the IKDC score and the Lysholm score before surgery,the KT-1000 test was performed and the femoral tunnel was drilled the outside-in technique in 25 patients and the traditional subpatellar anteromedial approach in the remaining 25 patients,routine rehabilitation training was carried out on the second day after operation.The related indexes were observed andanalyzed.3)30 patients who underwent ACL reconstruction from January to August 2019 were selected and divided them into three groups: Routine rehabilitation(routine rehabilitation treatment group),routine rehabilitation + suspension exercise(routine rehabilitation + suspension exercise treatment group),routine rehabilitation + blood flow control training(routine rehabilitation + blood flow control training group).The muscle strength and movement of the patients after ACL reconstruction were observed and compared before operation,1 month after operation and 3 months after operation.Results:1)The results of experiment showed that the length of point a was(9.70±0.66)mm,the Coefficient of variation was 2.13%,the length of point B was(8.86±1.45)mm,the Coefficient of variation was 3.98%,the length of point C was(8.90±1.27)mm,the Coefficient of variation was 3.75%,the length of point D was(9.40±0.62)mm,the Coefficient of variation was 2.04%,the length of point E was(9.90±0.65)mm,and the Coefficient of variation was 2.14%.2)There was no significant difference in the operation time between the two methods of femoral tunnel drilling(P > 0.05),but there was significant difference in the length of femoral tunnel(P < 0.05).There was no significant difference in IKDC score,Lysholm score and KT-1000 display numbers(P> 0.05)after3-month follow-up.3)The thigh circumference difference of the patients in the routine rehabilitation plus blood flow control training group was significantly less than that in the other two groups(P < 0.05)at the third month after operation.Conclusion: 1)The triangle of A,D and E is the ideal drilling area for ACL isometric reconstruction.The Posterior Superior Triangle of the anterior cruciate ligament(ACL)attachment point is the key area for surgical reconstruction.2)Compared with the anteromedial approach,both of them can achieve satisfactory clinical results,and we think that both of them can achieve better post-reconstruction isometric.3)Routine rehabilitation + suspension training can achieve the best motor function recovery effect,and routine rehabilitation + blood flow training can achieve the muscle strength recovery effect very well. |
PDF Full Text Request