自体与异体肌腱重建前十字韧带的对比研究

The Comparative Study of Anterior Cruciate Ligament Reconstruction with Autograft and Allograft Tendon

目的:探讨自体与异体肌腱重建前十字韧带(ACL)临床疗效与不良反应的差异。方法:选取本院膝关节ACL损伤患者98例,采用随机数字表法将其分为观察组与对照组。观察组50例,采用自体肌腱(取自体半腱及股薄肌腱)行关节镜下ACL重建术;对照组48例,采用异体肌腱(同种异体胫前肌腱)行关节镜下ACL重建术,比较两组的近远期疗效与不良反应率的差异。结果:观察组的术后发热时间明显短于对照组,两组比较差异有统计学意义(P<0.05)。两组手术后1、3、6、12个月Lachman与ADT试验阴性率、Lysholm与IKDC膝关节功能评分均明显高于手术前,手术前后比较差异均有统计学意义(P<0.05)。对照组出现免疫排斥反应3例,观察组无明显不良反应,两组的术后不良反应发生率比较差异无统计学意义(P>0.05)。结论:自体与异体肌腱重建ACL的临床疗效相当,但同种异体材料更容易出现免疫排斥风险,且价格较为昂贵,对于单纯性膝关节ACL损伤患者优先采用自体肌腱重建ACL。

Objective：To investigate the clinical efficacy and adverse reactions of autologous and allogeneic tendon reconstruction for anterior cruciate ligament（ACL）.Method： 98 patients with ACL injury were selected and divided into the observation group and the control group randomly.50 cases in the observation group were performed arthroscopic ACL reconstruction from autologous semi tendon and femoral thin tendon.48 cases in the control group were performed ACL reconstruction with allogeneic tendon（allogeneic anterior tibial tendon）,the short-term and longterm clinical efficacy and adverse reaction rate of the two groups were compared.Result：The postoperative fever time of observation group was significantly shorter than control group,the difference was statistically significant（P〈0.05）.The Lachman and ADT test negative rate, Lysholm and IKDC knee function score of two groups after surgery 1 month and 3,6,12 months were significantly higher than those of pre-surgery, the differences were statistically significant（P〈0.05）.In control group, there were 3 cases of immune rejection, the observation group had no obvious adverse reaction, the incidence of adverse reactions between the two groups was not statistically significant（P〉0.05）.Conclusion： The clinical efficacy of autologous and allogeneic tendon reconstruction of ACL are quite similar, but allogeneic tendon reconstruction is more prone to the risk of immune rejection and the price is more expensive,it is priority using autologous tendon reconstruction for simple knee joint ACL injury.