关节镜下自体腘绳肌腱和同种异体胫前肌腱解剖止点中点单束重建前交叉韧带的比较研究

Comparative study on arthroscopic reconstruction of single-bundle anterior cruciate ligament reconstruction being centered within autologous hamstring tendon and allogeneic anterior tibial muscle tendon

目的比较自体腘绳肌腱和同种异体胫前肌腱解剖止点中点单束重建前交叉韧带的近期临床效果。方法收集关节镜下利用自体腘绳肌腱和异体胫前肌腱解剖止点中点单束重建前交叉韧带随访满1年的病例。自体腘绳肌腱(简称自体组,32例)和同种异体胫前肌腱(简称异体组,21例)行前交叉韧带解剖止点中点单束重建手术。利用客观指标(双侧膝关节前向松弛度差异、Lachman试验、轴移试验)、Lysholm评分表和国际膝关节评分委员会(IKDC)膝关节评分表进行术后膝关节功能评估。结果术后患者切口均愈合,无关节内感染、下肢深静脉血栓形成和血管、神经损伤等并发症发生。两组患者术后1年Lachman试验、轴移试验、双侧膝关节前向松弛度差异、IKDC膝关节评分和Lysholm评分较术前均显著改善,差异有统计学意义(P<0.01),但组间比较差异无统计学意义(P>0.05)。结论应用自体腘绳肌腱和同种异体胫前肌腱解剖止点中点单束重建前交叉韧带均能取得优良的近期临床效果。

【Objective】To compare the short-term clinical effects of arthroscopic reconstruction of single-bundle anterior cruciate ligament reconstruction being centered within autologous hamstring tendon and allogeneic anterior tibial muscle tendon. 【Methods】This study collected the medical records of patients with arthroscopic reconstruction of single-bundle anterior cruciate ligament reconstruction being centered within autologous hamstring tendon and allogeneic anterior tibial muscle tendon, who had been followed up for a whole year. 32 cases were given reconstruction with autologous hamstring tendon（autologous group）, while 21 cases were given reconstruction with allogeneic anterior tibial muscle tendon（allogenetic group）. Objective indexes（Differences of bilateral knee joint laxity,Lachman test, and pivot shift）, Lysholm scale and IKDC scale were used for evaluation on knee joint function after operation. 【Results】Postoperative incisions of all patients wear healed. There were no complications such as intraarticular infection, deep venous thrombosis in lower limbs, and vascular and nerve injury. Lachman test, pivot shift,differences of bilateral knee joint laxity, IKDC and Lysholm scores of two groups of patients were significantly improved after operation, with statistically significant differences（P〈0.01）, but there were no significant differences between groups（P〈0.05）.【Conclusion】Arthroscopic reconstruction of single-bundle anterior cruciate ligament reconstruction being centered within autologous hamstring tendon and allogeneic anterior tibial muscle tendon can both obtain excellent short-term clinical effects.