同种异体肌腱移植重建治疗膝关节前交叉韧带断裂:中期随访评价

Reconstruction of anterior cruciate ligament with allogeneic tendon: a medium-term follow-up

背景:以同种异体肌腱移植重建前交叉韧带是现在较流行的手术方式,但缺乏中长期临床疗效的评价。目的:分析膝关节镜下同种异体胫前肌腱移植重建前交叉韧带的方法及其中期疗效。方法:回顾分析应用同种异体肌腱移植重建前交叉韧带的25例患者的临床资料,比较移植前及移植后3年以上的中期随访Lysholm、Tegner、IKDC关节评分。结果与结论:所有病例均获得随访。25例患者同种异体肌腱移植后Lysholm关节评分、Tegner评分和IKDC评分均显著高于移植前(均P<0.05)。所有病例移植后均未出现肺栓塞、感染、移植物断裂等并发症。关节功能明显改善。1例前抽屉试验弱阳性。Lachman试验征均为阴性,轴移试验均阴性。结果表明,关节镜下应用同种异体肌腱移植重建前交叉韧带具有创伤小,并发症少的优势,中期随访疗效优良。

BACKGROUND：Alogeneic tendon has been frequently used to reconstruct the anterior cruciate ligament. However, there is a lack of middle- and long-term clinical evaluation. OBJECTIVE：To evaluate the middle- and long-term curative effect of alogeneic tendon reconstruction of the anterior cruciate ligament under arthroscopy. METHODS：Twenty-five patients with anterior cruciate ligament injury under alogeneic tendon transplantation were reviewed retrospectively. They were al folowed up for 3 years or more. The clinical outcomes were evaluated and compared using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION：Al the patients were folowed up. Lysholm scale scores on the knee function, Tegner scores and IKDC scores were significantly increased after transplantation （P ＆lt; 0.05）. No complications of infection and compartment syndrome occurred. Symptoms were relieved and the function of knee joint was improved. There was one case weakly positive for anterior drawer test. Both Lachman test and pivot shift test showed negative signs. Overal, the reconstruction of anterior cruciate ligament with alogeneic tendon has less trauma and complications, with good middle-term efficacy.