CLINICAL APPLICATION OF MULTIDISCIPLINARY DIAGNOSIS AND TREATMENT TO PROMOTE RAPID REHABILITATION OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION DURING PERIOPERATIVE PERIOD

Yongjun Du¹, Yongdong Tang², Yuanze Gao³, Changbao Zhu¹, Hui Xiao¹, Cao Chen^{1, *}

¹Department of Trauma Orthopaedics, Beijing Road Medical Zone, General Hospital of Xinjiang Military Region, Urumqi, China - ²Department of Joint Surgery, Shihezi Peoples Hospital, Xinjiang, China - ³Microsurgery of the Third People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China

Introduction: To explore the clinical application value of multi-disciplinary treatment (MDT) in promoting the rapid rehabilitation of anterior cruciate ligament reconstruction of knee joint during the perioperative period.

Materials and methods: In this project, 50 patients who were clinically diagnosed as anterior cruciate ligament injury and underwent cruciate ligament reconstruction from June 2018 to June 2020 were selected as the research objects. They were randomly divided into an experimental group (multi-disciplinary treatment group) with 25 cases and a control group (traditional treatment group) with 25 cases. Experiment group: A multi-disciplinary treatment group composed of orthopedic doctors, nurses, anesthesiologists, and rehabilitation doctors worked out an integrated treatment plan of perioperative preoperative preparation, pain management, and rehabilitation training. The control group was given the traditional treatment, and the orthopedic surgeon designated the perioperative treatment plan. The patients were treated without the participation of anesthesiologists and rehabilitation doctors. All patients were followed up for 6 months after operation. Knee joint pain of the two groups was evaluated by visual analogue scale (VAS) before operation, 6 h after operation, 24h after operation and 72h after operation. The time required for knee joint flexion of the two groups of patients to 30 , 60 , 90 and 120 after operation was recorded. Lysholm scoring method was used to score the knee joint function of the two groups before operation, 1 month, 3 months and 6 months after operation, and the results were compared.

Results: The VAS scores of knee joint pain in multi-disciplinary treatment group before operation, 6h, 24h and 72h after operation were lower than those in traditional treatment group, and the differences were statistically significant (t=8.004,6.913,5.743,5.882, P<0.05). The time required for knee joint flexion to 30 , 60 , 90 and 120 after operation in multi-disciplinary treatment group was shorter than that in traditional treatment group, and the differences were statistically significant (t=5.062, 8.850, 6.909, 9.331, P<0.05). There was no significant difference in Lysholm scores of knee joint function between the two groups before the operation, but the Lysholm scores of knee joint function in multi-disciplinary treatment group were higher than those in traditional treatment group 1,3,6 months after operation, and the differences were statistically significant (t=17.411,10.562,13.437, P<0.05). 

Conclusion: Multi-disciplinary treatment could significantly reduce the pain of patients after anterior cruciate ligament reconstruction, facilitate the early functional exercise of knee joint and promote the rapid recovery of knee joint function.