关节镜下前交叉韧带重建两种固定方法比较

The contrast and observing of two fixation methods in arthroscopic anterior cruciate ligament reconstruction

目的对比研究关节镜下自体腘绳肌腱单束移植重建前交叉韧带中分别应用横穿钉/膨胀钉固定股骨/胫骨隧道与应用可吸收界面螺钉(Bioscrew)固定的临床效果。方法将68例前交叉韧带断裂的患者分为两组:A组33例采用Rigidfix与Intrafix固定腘绳肌腱重建前交叉韧带;B组35例采用Bioscrew固定腘绳肌腱重建前交叉韧带。术后按照同样康复计划进行康复训练。结果两组随访12～23个月,以术后12个月为参照点,两组膝关节活动度恢复良好,无主动伸直障碍,A组2例、B组3例患者出现隐神经损伤症状。术后Lysholm评分A组为(93.7±0.8)分,B组为(90.1±3.6)分,两组间手术后对比差异无统计学意义(P>0.05),组内比较手术前后Lysholm评分差异有统计学意义(P<0.05)。结论关节镜下应用Rigidfix及Intrafix固定腘绳肌腱重建前交叉韧带固定牢固愈合可靠,与Bioscrew的临床效果相当,并发症少,避免了肌腱切割、偏心固定、螺钉断裂等问题,值得临床推广。

Objective To observe the clinical outcome of arthroscopic anterior cruciate ligament（ACL）single bundle reconstruction with Rigidfix/Intrafix between Bioscrew. Methods A total of 68 cases were involved in this retrospective study and were divided into two groups.33 cases underwent reconstruction with Rigidfix and Intrafix and 35 cases treated with Bioscrew. The postoperative protocols of both groups were similar.The follow- up ranged from 12 to 23 months.The Lysholm scores was recorded and compared preoperatively and 12-months postoperatively. Results The postoperative range of motion recovered well and no extension lag were found.There are 2 and 3 cases developed symptoms of saphenous nerve injury respectively to the two groups.The postoperative Lysholm scores were（93.7 ± 0.8） and （90.1 ±3.6） respectively and had no statistical difference as well as the preoperative comparison.However,the postoperative and preoperative Lysholm scores of each group had statistical differences, Conclusion Arthroscopic anterior cruciate ligament（ACL）reconstruction with Rigidfix and Intrafix is safe,reliable.The clinical outcome of them is similar to Biocscrew.There are fewer complications. This is an excellent choice of surgeons.