关节镜下自体腘绳肌和同种异体肌腱在重建前交叉韧带中的应用研究

Efficacy of arthroscopic autologous hamstring and allogeneic tendon in reconstruction of anterior cruciate ligament

目的:比较分析关节镜下自体腘绳肌与同种异体肌腱在重建前交叉韧带(ACL)中的应用疗效。方法:随机数表法将64例ACL损伤患者分为自体组(自体腘绳肌)与异体组(同种异体肌腱)各32例,比较两组手术时间、发热时间、术前、术后12个月ADT试验、Lachman试验、IKDC评分、Lysholm评分及Tegner评分变化,同时术后3个月、12个月行患侧膝关节被动角度再生试验。结果:自体组手术时间显著长于异体组、发热时间显著短于异体组(P<0.05);两组术后12个月ADT试验、Lachman试验、IKDC评分、Lysholm评分、Tegner评分及患侧膝关节被动角度再生试验结果比较无统计学差异(P>0.05);自体组术后3个月患侧膝关节60°、90°位再生试验结果与异体组比较差异有统计学意义(P<0.05)。结论:关节镜下自体腘绳肌与同种异体肌腱治疗ACL疗效相当,前者虽然手术时间长,但发热时间短,术后膝关节本体感觉恢复比后者早。

Objective:To compare the efficacy of arthroscopic autologous hamstring and allogeneic tendon in reconstruction of anterior cruciate ligament(ACL).Methods:64 patients with ACL injury were divided into the autologous group(autologous hamstring)and allogeneic group(allogeneic tendon)by the random number table method,with 32 cases in each group.The operation time,duration of fever,as well as ADT test,Lachman test,IKDC scores,Lysholm scores and Tegner scores before operation and 12 months after operation were compared between the two groups.The affected knee passive angle regeneration test was performed at 3 months and 12 months after operation.Results:The operation time of the autologous group was significantly longer,and the duration of fever was significantly shorter than those of the allogeneic group(P < 0.05).The results of ADT test and Lachman test,IKDC scores,Lysholm scores,Tegner scores and the scores of affected knee passive angle regeneration test 12 months after operation showed no significant differences between the two groups(P>0.05).There were significant differences in the results of affected knee 60 and 90 degrees regeneration test between the two groups 3 months after operation(P<0.05).Conclusion:The efficacy of arthroscopic autologous hamstring in the treatment of ACL is similar to allogeneic tendon.Although the operation time of the former is longer,the duration of fever is shorter,and the recovery of knee proprioception is faster after operation.