关节镜下骨-髌腱-骨重建前交叉韧带5年以上随访分析

Five-years following-up analysis of clinical effect about arthroscopic reconstruction of anterior cruciated ligament by using bone-patella tendon-bone

目的探讨骨-髌腱-骨(BPTB)在前交叉韧带(ACL)损伤重建后的的远期疗效。方法 1999年1月～2003年6月该院行自体或同种异体BPTB重建ACL韧带123例,采用Lysholm膝关节功能评分法、IKDC评分法及KT1000检测分别评定术后1个月、3个月、6个月、1年、2年及5年等不同时期膝关节功能情况。结果 98例得到5年以上随访,91例患者膝不稳症状消失,关节功能恢复良好。8例合并膝前疼痛,25例感觉伸膝乏力,7例在2年后感觉关节轻度不稳,8例关节功能受限。重建术后6个月Lysholm评分、IKDC评分与术后1个月相比差异有显著性,术后2年与术后6个月相比差异有显著性,但重建术后5年与重建术后2年相比差异无显著性,且术后5年的评分总体满意。结论自体与同种异体中1/3BPTB重建ACL远期临床疗效满意。

【Objective】To evaluate the prospective efficacy of reconstruction of anterior crucicate ligament by mid one third bone-patella tendon-bone. 【Methods】Retrospective study the 123 patients with rupture of ACLs were operated upon arthroscopic by autologus or variant mid one third bone-patella tendon-bone. Lyshoim,IKDC knee scores system and KT1000 were used to evaluate the knee function after operation in 1 month,3 months,6 months,1 years,2 years and 5 years. 【Results】98 Patients were followed up for over 5 years. The instability of 91 knees disappeared. The complication of antero -knee pain and hypodynamic kness occurred in 8 and 25 cases respectively. 2 patients felt unstable slightly and 8 kness were restricted in the range of motion after 2 years. Compared with Lysholm and IKDC knee scores of 1 month after operation,the scores after 6 months were lower,and the difference was present. There was significant difference in the scores between the operation after 2 year and 5 years,but the scores between the operation after 2 years and 5 years,no significant difference was obvious. 【Conclusions】Arthroscopic reconstruction of ACL with autologus or variant mid one third bone-patella tendonbone has satisfactory effects.