重建前交叉韧带中Endo-Button和可吸收界面螺钉固定的对比

Anterior cruciate ligament reconstruction using Endo-Button versus absorbable interference screw fixation systems

背景:应用腘绳肌肌腱重建前交叉韧带过程中仍有许多的争议及未知因素需进一步探讨和研究。目的:比较分析腘绳肌肌腱重建前交叉韧带过程中股骨端分别使用Endo-Button系统和可吸收界面螺钉两种不同固定方式的疗效。方法:选择45例在关节镜下使用4股自体腘绳肌腱进行前交叉韧带重建患者,实验组25例股骨端使用Endo-Button钢板固定,对照组20例使用可吸收界面螺钉固定。重建后用相同的方法进行康复锻炼。结果与结论:经过6-21个月的随访,患者膝关节屈伸活动度均达正常范围。Lachman试验中实验组Ⅰ度阳性2例,对照组Ⅰ度阳性3例;轴移试验均阴性。两组重建后膝关节Lysholm评分均较治疗前明显改善,两组间差异无显著性意义。两组随访早期均有较高的骨道扩大发生率,但组间差异无显著性意义;对照组骨道增宽程度强于实验组(P<0.05)。说明两组早期总体临床效果相近。

BACKGROUND： The anterior cruciate ligament （ACL） reconstruction by using hamstring tendon autografts faces a lot of controversy and unknown factors.OBJECTIVE： To explore the difference between the Endo-Button and the absorbable interference screw system in the ACL reconstruction.METHODS： The experiment group （n=25） were reconstructed arthroscopically with semitendionosus and gracilis tendons by Endo-Button. The control group （n=20） were reconstructed by the absorbable interference screw.Same rehabilitation training was conducted in the two groups after reconstruction.RESULTS AND CONCLUSION： The patients were followed up from 6 to 21 months. Range of motion of the knee was normal in the two groups. In the Lachman test, there were two cases of positive Ⅰ in the experimental group and three cases of positive Ⅰ in the control group. However, all the patients showed negative results in the pivot shift test. The statistical difference in the Lysholm knee score was significant before and after the reconstruction, but there was no difference between the two groups. After analyzing the incidence rates of the tunnel enlargement, there was no statistical difference between the experiment group and the control. But the tunnel enlargement of the control group was bigger than that of the experimental group （P 〈 0.05）. These findings indicate that the early clinical effects of Endo-Button and absorbable interference screw fixation systems are similar.