前交叉韧带单束重建和双束解剖重建短期临床疗效的病例对照研究

Case control study on clinical effects of arthroscopic single versus double bundle ACLs reconstructions

目的:比较关节镜下采用单束重建和双束重建前交叉韧带的临床效果。方法:自2009年1月至2010年5月,45例前交叉韧带撕裂患者分别行前交叉韧带解剖双束重建(双束重建组)和自体腘绳肌腱前交叉韧带单束重建(单束重建组)。双束组22例,男15例,女7例;年龄(27.04±3.68)岁;运动损伤3例,交通损伤19例。单束组18例,男13例,女5例;年龄(28.16±4.76)岁;运动损伤2例,交通损伤16例。按照IKDC、Lysholm膝关节评分标准及Lachman试验、轴移试验及KT-1000评估疗效。结果:双束重建组22例、单束重建组18例均获随访,时间12个月。单束重建组IKDC评分从术前(41.40±6.30)分提高至(95.70±3.10)分;Lysholm评分从(47.20±6.30)分提高至(94.20±2.40)分,双束重建组IKDC评分从术前(40.90±6.10)分提高至(96.10±3.40)分,Lysholm膝关节评分从术前(48.10±6.50)分提高至(95.10±2.49)分,两组差异无统计学意义。两组患者中均有1例Lachman试验I度阳性,1例轴移试验阳性。双束重建组KT-1000值(1.5±1.2)mm,单束重建组KT-1000值(1.9±1.5)mm,两组差异无统计学意义。结论:关节镜下采用单束重建和双束重建前交叉韧带临床疗效无明显差异。

Objective：To compare the clinical results of arthroscopic single and double bundle ACLs reconstructions. Methods：From January 2009 to May 2010,45 patients with anterior cruciate ligament tear were divided into two groups. In the first group,the anterior cruciate ligament were anatomical reconstructed with double bundle semitendinous tendon,and in the second group the anterior cruciate ligaments were anatomical reconstrucated with single bundle semitendinous tendon. There were 22 patients（15 males and 7 females） in double bundle group,with an average age of （27.04±3.68） years;18 patients（13 males and 5 females） in single bundle group,with an average age of （28.16±4.76） years. Therapeutic effects between two groups were compared according to the IKDC,Lysholm scoring standards and Lachman test,knee pivot shift test,KT-1000. Results：Twenty two patients in double bundle group and 18 patients in single bundle group were followed up,and the mean duration was 12 months. The IKDC score of patients in single bundle group improved from preoperative 41.40±6.30 to postoperatively 95.70±3.10,Lysholm score increased from preoperative 47.20±6.30 to postoperative 94.20±2.40. And the IKDC score of patients in double bundle group improved from preoperative 40.90 ±6.10 to postoperative 96.10 ±3.40,Lysholm score increased from preoperative 48.10±6.50 to postoperative 95.10±2.49. There was no statistically significant difference between the two groups. The Lachman test was positive in 2 patients （1 patient in double bundle group and 1 patient in single bundle group）;and pivot shift test was positive in 2 patients （1 patient in double bundle group and 1 patient in single bundle group）. KT-1000 of patients in double bundle group was （1.5±1.2） mm,and （1.9±1.5） mm in single bundle group,there were no statistically significant differences between the two groups. Conclusion：Arthroscopic single bundle reconstruction and double-bundle anterior cruciate ligament reconstruction have no significant differences in clinical effects.