了解不同康复途径对膝关节脱位手术后康复训练效果的影响。

回顾性研究中国人民解放军联勤保障部队第九〇八医院2015年10月至2018年9月膝关节脱位合并韧带损伤的患者。按照纳入、排除标准，共纳入67例研究对象，根据术后患者康复锻炼的途径，分为2组，远程指导组39人、机构康复组28人。比较术后1年2组患者膝关节Lysholm评分、国际膝关节文献委员会膝关节评估表(简称IKDC评分)、关节活动度(ROM)、术后康复训练直接花费，行t检验，记录切口感染、急性骨筋膜室综合征、手术相关血管神经损伤等并发症情况。

2组患者术后1年的膝关节Lysholm评分(t＝－1.722)、IKDC评分(t＝－1.184)、ROM(t＝－1.695)大致相当(P>0.05)；但远程指导组术后康复训练直接花费(t＝－73.509)比机构康复组患者明显降低(P<0.05)。远程指导组中有2例(5.12%)、机构康复组中有1例(3.57%)出现手术切口红肿，均予以抗生素抗感染、伤口换药后治愈，随访期间未发现膝关节感染；所有患者均未出现骨筋膜室综合征或手术相关血管神经损伤。

膝关节脱位合并韧带损伤手术后采取远程视频指导下的康复训练，与在康复机构进行训练相比较，可以取得一致的膝关节功能恢复，但花费明显降低。

To explorethe effect of different rehabilitation approaches on rehabilitation training after knee dislocation surgery.

A retrospectively study was carried out on the patients with knee dislocation combined with ligament injury in No.908 Hospital of Chinese PLA from October 2015 to September 2018.Inclusion criteria: knee dislocation (self-reduction included), Schenck classification of KD-Ⅰ, KD-Ⅲ, unilateral injury, treated by arthroscopy. According to the inclusion and exclusion criteria, a total of 67 subjects were included in the study and were divided into two groups (39 in the remote guidance group and 28 in the institutional rehabilitation group) according to the way of rehabilitation exercise after surgery. The Lysholm score, the International Knee Committee (IKDC) knee evaluation score, range of motion (ROM) of knee joints and the direct cost of rehabilitation training were compared between the two groups one year after operation, and compared by t-test. Incision infection, acute compartment syndrome, surgery-related vascular nerve injury and other complications were recorded.

The Lysholm score(t=-1.722), IKDC score(t=-1.184) and ROM(t=-1.695) of knee joints of the two groups at one year after operation were roughly equivalent (P>0.05), but the direct cost (t=-73.509) of rehabilitation training in the remote guidance group was significantly lower than that in the institutional rehabilitation group (P<0.05). Two patients (5.12%) in the remote guidance group and one patient (3.57%) in the institutional rehabilitation group had redness and swelling of the surgical incision, all of them were cured after the application of antibiotics and wound dressing change, and no infection of knee joint was found during the follow-up period. None of the patients had acute compartment syndrome or surgery-related vascular nerve injury.

Rehabilitation training guided by remote video after knee dislocation combined with ligament injury can achieve consistent knee function recovery compared with training in rehabilitation institutions, but the cost is significantly reduced.