关节镜下自体腘绳肌和异体胫前肌单束重建前交叉韧带的1年随访比较

Autologous hamstring grafts versus allogeneic anterior tibial muscle tendon grafts for arthroscopic reconstruction of single-bundle anterior cruciate ligament:A one-year follow-up

背景:由于人工韧带存在慢性疲劳,越来越多的人采用异体肌腱重建前后交叉韧带损伤。目的:比较关节镜下自体腘绳肌和异体胫前肌单束重建前交叉韧带的疗效。方法:收集关节镜下用自体腘绳肌和异体胫前肌单束重建前交叉韧带随访满1年的病例。自体腘绳肌重建前交叉韧带组28例;异体胫前肌重建前交叉韧带组18例。采用股骨端Endobutten、胫骨端可吸收螺钉固定。采用支具固定并进行功能训练。结果与结论:前交叉韧带重建后6个月,异体肌腱组lysholm评分高于自体肌腱组(P<0.05);重建后12个月两组lysholm评分差异无显著性意义。两组重建后6,12个月与重建前比较差异均有显著性意义(P<0.05),重建后12个月与6个月比较差异有显著性意义(P<0.05)。结果表明,自体和异体肌腱重建前交叉韧带随访1年疗效相当。

BACKGROUND： Due to artificial ligament has chronic fatigue, more and more people use allograft for the reconstruction of anterior and the posterior cruciate ligament injury. OBJECTIVE： To compare the curative effect after arthroscopic reconstruction of single-bundle anterior cruciate ligament using autologous hamstring grafts and allogeneic anterior tibial muscle tendon grafts. METHODS： Cases of anterior cruciate ligament reconstruction which using single-bundle autologous hamstring grafts and allogeneic anterior tibial muscle tendon grafts under arthroscopic with 1 year follow-up were collected. Totally 28 cases were used autologous hamstring grafts for anterior cruciate ligament reconstruction, and 18 cases were used anterior tibial muscle tendon allograft for anterior cruciate ligament reconstruction. The fixation of each reconstructed anterior cruciate ligament was done by femoral EndoButton and tibial biodegradable interference screw. Using a brace to fix the troubled knee and having the physical training of the troubled knee lately and progressively. RESULTS AND CONCLUSION： All the 46 cases were followed up for six months after reconstruction. Lysholm score of the autologous tendon group was lower than that of the allogeneic tendon group （P 〉 0.05）. There was no significant difference between the two groups of Lysholm score after six months postoperatively. Lysholm score of the two groups after 6 months and a year construction postoperative showed significant difference as compared with preoperation （P 〈 0.05）. There was significant difference of the Lysholm score after reconstruction in six months follow-up and in one year follow-up showing a statistic significance （P 〈 0.05）. The curative effect of anterior cruciate ligament reconstruction using autologous hamstring grafts and allogeneic anterior tibial muscle tendon grafts is equally.