关节镜下双束及单束单隧道重建膝前交叉韧带的疗效比较

A comparative study on the clinical effects of arthroscopic reconstructions of anterior cruciate ligament with single-bundle and double-bundle single tibial tunnel

目的探讨关节镜下前交叉韧带(ACL)损伤后双束及单束单隧道重建的近期临床疗效差异。方法我科自2008年1月至2011年6月对38例ACL损伤患者进行关节镜下韧带重建,其中双束单隧道重建21例(A组),传统单束单隧道重建17例(B组)。所有患者术前及随访时均进行IKDC2000、Larson和Lysholm评分比较手术前后膝关节功能,并对结果进行统计学分析。结果 38例患者(38个膝关节)获得随访,随访时间12～36个月,平均25个月。关节活动度均正常,A组手术前后的Lysholm评分,Larson评分及IKDC评分均有统计学差异,B组手术前后的3种评分同样有统计学差异;A、B两组比较,除了术后Larson评分双束组优于单束组(P<0.05)外,其余均无统计学意义。结论关节镜下ACL胫骨端双束单隧道重建与传统单束重建,均能取得较为满意近期临床疗效,双束组可能优于单束组,但有待进一步证实。

Objective To discuss the clinic differences between arthroscopic ACL reconstructions with single-bundle and double-bundle single tibial tunnel after ACL injury. Methods A total of 38 cases of arthroscopic ACL reconstruction were involved in this study from January 2008 to June 2011, including 21 double-bundle ones （Group A） and 17 single-bundle ones （Group B）. The IKDC2000, Larson and Lysholm scores were compared for every patient before and after operation. Results All the 38 patients were followed up from 12 to 35 months （an average of 25）, which contained 38 examples of knee joints. The mobility of joint was normal in patients of both group A and B after operation. As regard of IKDC2000, Larson and Lysholm scores, the differences in group A or Group B were significant before and after operation （P〈0.001）. In the comparison between group A and group B, postoperative Larson score of group A was superior to the group B and the other scores were no statistical difference. Conclusion Both double-bundle and single-bundle single tunnel reconstruction by arthroscope could achieve excellent clinical effect in treatment of ACL injury. The double-bundle method looks better than single-bundle method according Larson score, but it needs to be further confirmed.