Comparasion of clinical outcomes of reconstruction by LARS and conservative treatment for patients older than 50 years with chronic forward instability of knee joint / 中国综合临床

ABSTRACT

Objective To compare the outcomes between conservative treatment and reconstruction with LARS in patients over 50 years old with chronic forward instability of knee joint.Methods Forty patients with chronic forward instability of knee joint from May,2005 to September,2013 in Shengjing Hospital of China Medical University were included in this study and were divided into conservative treatment group(16 cases) and LARS group(19 cases) besides that were ineligible according to different treatment methods.All patients were followed up for two years.The evaluation indicators included Lysholm,IKDC,Tegner,ROM,Kneelax and Kellgren-Lawrence rating.Results At the end of two-year follow-up,the knee joint function score of conservative treatment group was significantly higher than that before treatment (Lysholm score after treatment (83.4± 12.5) points,before treatment (69.6 ± 10.4) points,t =-11.502,P =0.00;IKDC after treatment,abnormal 2 cases,and before treatment,abnormal 10 cases,P =0.00;Tegner after treatment 6 (1,9) points,before treatment 3 (1,5) points,Z =-3.471,P =0.01).The knee joint function score and Kneelax measurement in the LARS ligament reconstruction group were significantly improved after operation(Lysholm score after treatment (80.0±14.2) points,before treatment (68.7±9.6) points,t =-7.875,P =0.00;IKDC score after treatment,abnormal 2 cases,and before treatment,abnormal 13 cases,P =0.00;Tegener score after treatment 8 (1,9) points,before treatment 3 (1,5) points,Z =-3.879,P=0.00;Kneelax score after treatment (1.5 ± 0.8) mm,before treatment (4.2 ± 0.8) mm,t =9.955,P =0.00).At the end of two-year follow-up,kneelax and Tegner scores in LARS ligament reconstruction group were significantly higher than those in conservative treatment group (Z =6.109,P=0.00;Z =2.672,P =0.01).Conclusion Compared with conservative treatment,LARS ligament reconstruction is more conducive to the stability and functional recovery of knee joint in patients over 50 years old with chronic anterior instability of knee joint.