关节镜下异体与自体肌腱联合编织重建前交叉韧带

Reconstruction of Anterior Cruciate Ligament with Allo-autologous Tendon Grafts under Arthroscopy

目的探讨关节镜下异体与自体肌腱联合重建前交叉韧带(anterior cruciate ligament,ACL)的临床疗效。方法自2006年5月至2009年12月2股异体肌腱及2股自体绳肌腱联合重建ACL并获得随访41例。通过随访,分析异体与自体肌腱联合重建ACL术后2年时膝关节应力试验情况及术后2年时膝关节Lysholm评分情况。结果 41例患者术后均未发生急慢性感染、排异反应、屈膝无力,轴移试验均为阴性,术后2年后前抽屉试验及Lach-man试验为阴性或度阳性,膝关节Lysholm评分(90.95±4.84)分,与术前膝关节Lysholm评分(52.34±8.45)分相比较差异有统计学意义(t=26.40,P=0.00)。结论异体与自体联合肌腱作为移植物重建ACL在临床上安全可靠,可作为前交叉韧带重建移植物的一种选择方式。

Objective To evaluate therapeutic effects for reconstruction of anterior cruciate ligament with allo-autologous tendon grafts under arthroscopy.Methods From May 2006 to December 2009,forty-one patients were performed ACL reconstruction with 2 strand allograft tendons and 2 strand autologous hamstring tendons jointly and were followed up.Throught follow-up above 2 years,knee stress tests and knee Lysholm scores were analysed.Results There was not acute and chronic infection,allograft rejection and weak knee in cases.Pivot-shift tests were negative in all patients.ADT and Lachman tests were negative or gradeⅠpositive.There was statistical significance in knee Lysholm scores between 52.34±8.45 preoperatively and 90.95±4.84 postoperatively（t=26.40,P=0.00）.Conclusion Allo-autologous tendon is a safe and reliable graft for ACL reconstruction and can be used as an alternative graft.