关节镜下髌韧带与腘绳肌腱重建前交叉韧带的疗效比较与探讨

Arthroscopic anterior cruciate ligament reconstruction:a comparison between bone-patellarten-don-bone autograft and hamstring tendon autograft

目的比较分析膝关节镜下自体髌韧带与腘绳肌腱移植重建前交叉韧带ACL的疗效。方法回顾分析32例膝关节镜下自体髌韧带移植重建ACL及44例自体腘绳肌腱移植重建ACL的情况,随访3、6、9个月。采用Lysholm膝关节评分、国际膝关节文献编制委员会分级评估标准。结果两组间患者满意度、关节稳定性及功能差异均无统计学意义。结论关节镜下髌韧带与腘绳肌腱移植重建ACL的疗效相同。ACL重建中等长重建、牢固固定及早期康复锻炼对疗效更有决定作用。

Objective To evaluate arthroscopic reconstruction of a tom anterior cruciate liga-ment with either a central-third bone-patellar tendon-bone autograft or a two-strand sem itendinosus-gracilis autograft and compare the results of clinical testing, satisfaction and functional status. Methods A retrospective study was done on 32 cases undergoing reconstruction with an ipsilateral central-third bone-patellar tendon-bone autograft and 44 treated with an ipsilateral four-strand sere itendinosus-gracilis auto-graft. Patients were followed up for 3 months,6 months,9 months. At the time of final follow-up, patients in each group were evaluated by Lysholm knee score, International Knee Documentation Committee （IKDC） rating scale. Results No statistical difference was found between the groups in regard of the Lysholm knee score, overall IKDC score that stand for patient satisfaction, knee function and objecttive stability,respectively. Conclusion The bone-patellar tendon-bone autograft and the four-strand sem itendinosus-gracilis autograft can attain comparable results for anterior cruciate ligament reconstruction in regard to patient satisfaction, knee stability and knee function in the mediumterm follow-up. However, reconstruction of anatomic attachment sites, firm initial fixation and a structured postoperative rehabilitation program may have more influence on clinical outcomes and knee stability.