膝关节镜下自体腘绳肌肌腱和髌腱移植重建前交叉韧带的效果观察

Observation of the Efficacy of Autologous Hamstring Tendon vs .Patellar tendon Transplantation under Knee Arthroscope for Anterior Cruciate Ligament Reconstruction

【目的】比较使用关节镜下自体腘绳肌肌腱和髌腱移植重建前交叉韧带两种方法治疗前交叉韧带损伤的临床疗效。【方法】选取本院骨科收治的78例前交叉韧带损伤的患者，按照不同的治疗方式分为治疗A组39例和治疗B组39例，其中A组采用自体腘绳肌肌腱移植重建方法治疗，B组采用髌腱移植重建方法治疗。分别观察患者术前术后的膝关节功能评分Lysholm、膝关节稳定性评分情况，术后的一般情况及并发症情况，对全部患者随访1年。【结果】两组患者术后的Lysholm评分、膝关节稳定性评分情况均优于手术前，且差异具有统计学意义（P ＜0．05），但术后两组的差异无统计学意义（P ＞0．05）。B组在术后发生并发症3例，A组未发生并发症，两组间差异具有统计学意义（ P ＜0．05）。【结论】选用采用自体腘绳肌肌腱移植重建方法治疗前交叉韧带损伤的效果与髌腱移植重建方法疗效相当，但前者的术后并发症少，平均手术时间短，适合在临床上推广和应用。

[Objective]To compare the clinical efficacy of arthroscopic autologous hamstring tendon vs .patellar ten-don graft for anterior cruciate ligament reconstruction after anterior cruciate ligament damage .[Methods]Totally 78 pa-tients with anterior cruciate ligament injury in orthopedics department of our hospital were chosen .According to different treatment methods ,all patients were randomly divided into treatment group A （ n=39） and treatment group B（ n=39） . Group A was reconstructed with autologous hamstring tendon transplantation ,while group B was reconstructed with pa-tellar tendon graft .Knee joint function score（Lysholm） ,knee joint stability score before and after operation ,general and complicated situation after the operation were observed .All the patients were followed up for 2 years .[Results]Lysholm score and knee joint stability score in group A and group B after operation were better than those before operation ,and there was significant difference between before and after operation （ P〈0 .05） ,but there was no significant difference be-tween two groups（ P〉0 .05） .The postoperative complications occurred in 3 patients of group B ,while group A had no complication ,and there was significant difference between two groups （ P 〈0 .05） .[Conclusion]The efficacy of autolo-gous hamstring tendon transplantation reconstruction for the treatment of anterior cruciate ligament injury is equal to pa-tellar tendon transplantation reconstruction .However ,the former has less postoperative complications and short operation time ,so it is suitable for clinical promotion and application .