自体腓骨长肌腱和腘绳肌腱在关节镜下重建膝关节前交叉韧带临床研究

Clinical Research on Reconstruction of Anterior Cruciate Ligament by Autogenous Peroneus Longus Tendon and Hamstring Tendon Ligament under Arthroscope

目的探讨关节镜下自体腓骨长肌腱和腘绳肌腱重建膝关节前交叉韧带的临床疗效.方法选取47例前交叉韧带损伤患者,应用随机数字表法将患者分为两组,分别行关节镜下腓骨长肌腱(A组)与腘绳肌腱(B组)重建膝关节交叉韧带,比较两组患者术后一般情况;分析两组患者术前、术后3个月、术后6个月的膝关节功能、稳定性,分析腓骨长肌腱组足弓的静力学变化.结果术后随访时,A组大腿周长减小与B组比较差异无统计学意义(P>0.05);两组患者术后Tegner评分、Lysholm评分、IKDC评分结果差异无统计学意义(P>0.05);A,B两组患者术后胫骨前移比较差异无统计学意义(P>0.05);A组患者足弓情况与术前比较,术后6个月、术后1 a足弓的静力学指标无明显变化(P>0.05).结论自体腓骨长肌腱重建膝关节前交叉韧带断裂与自体腘绳肌腱取得的临床效果相当.

Objective To explore the clinical efficacy of arthroscopic autogenous peroneus longus tendon and hamstring tendon on the reconstruction of anterior cruciate ligament. Method 47 patients with anterior cruciate ligament injury were randomly divided into two groups. The patients＇ anterior cruciate ligament were reconstructed by arthroscopic peroneus longus tendon（ group A） and hamstring tendon（ group B）,respectively. The postoperative general information of the patients were compared between the two groups. The knee joint function and stability of the patients were analyzed before treatment,and at the 3 rd month and 6 th month after surgery,and the arch statics changes of the patients in group A were also analyzed. Results The decrease in thigh circumference of the patients in the two groups showed no statistical difference（ P 0. 05）. The postoperative Tegner score,Lysholm score and IKDC score between the two groups was not significant difference（ P0. 05）. In group A,there was no significant difference in arch statics index before operation and at the 6 th month and 1 st year after surgery（ P0. 05）. Besides,no postoperative valgus was found in group A,and the patients had normal plantar flexion range and level V muscle strength. Conclusion The clinical efficacy of arthroscopic autogenous peroneus longus tendon and hamstring tendon on the reconstruction of anterior cruciate ligament is the same. And the statics structure of foot arch is not affected obviously after peroneal longus tendon cut.