胫骨侧单重与双重固定重建前交叉韧带的比较研究

Comparison between Single and Dual Tibial Fixation for Anterior Cruciate Ligament Reconstruction

目的:比较胫骨侧单重固定与双重固定在关节镜下以自体腘绳肌重建前交叉韧带的临床效果。方法:对2008年1月～2011年12月期间在我院接受前交叉韧带重建术的80例患者进行回顾性随访,比较胫骨侧单重固定与双重固定的临床疗效,在末次随访时检查患者Lachman试验、轴移试验、前抽屉试验、关节活动范围、在30°及90°位胫骨的位移度、IKDC评分、Lysholm评分、Tegner评分。结果:膝关节活动范围双重固定组(137±21)°大于单重固定组(123±23)°(P<0.01),在30°及90°位胫骨的位移度,双重固定组均小于单重固定组(P<0.05),双重固定组膝关节Lysholm评分94.3±6.9、IKDC评分86.3±9.8,单重固定组Lysholm评分89.2±7.8,IKDC评分81.7±10.3,两组间具有显著性差异(P<0.01),两组间Tegner评分无统计学差异(P>0.05)。结论:在关节镜下行自体腘绳肌前交叉韧带重建,胫骨侧移植物附加Suture Disc纽扣钢板固定的双重固定临床效果优于单重界面螺钉固定。

Objective： To compare clinical outcomes of tibial ？xation between single and dual tibial fixation for arthroscopic anterior cruciate ligament reconstruction with harmstring autograft.Methods： Follow up 80 patients who underwent ACL reconstruction during Jan 2008 to Dec 2011.Compare clinical effect of single tibia fixation and dual tibia fixation.The Lachman test,pivot-shift test,anterior drawer test,range of knee motion,International Knee Documentation Committee（IKDC） score,Lysholm score and Tegner score were evaluated at the last follow-up.Results： Range of knee motion in dual fixation group（137±21） °were larger than single group（123±23）°（P0.05）.Both in 30°and 90°position tibia movement in single fixation group were larger than dual fixation group（P0.05）.Lysholm score is 89.2±7.8 in single fixation group while 94.3±6.9 in dual fixation group.IKDC score is 81.7±10.3 in single fixation group while 86.3±9.8 in dual fixation group.Statistical difference is significant（P0.01）.There was no statistical difference in Tegner score between the two groups（P0.05）.Conclusion： Supplementary tibial fixation with Suture Disc in ACL reconstruction using harmstring autograft was more effective than a interference screw only in restoration of the anterior stability of the tibia.