前交叉韧带重建术取腱切口的比较

Comparison of Tendon Incisions for Anterior Cruciate Ligament Reconstruction

目的研究前交叉韧带重建术中,不同取腱切口的优缺点。方法选取2015年1月至2018年1月于南京中医药大学附属姜堰中医院进行关节镜下髌腱中1/3重建交叉韧带重建手术患者92例,按照手术方法的不同分为横切口组40例和纵切口组52例。比较两组手术平均时间、标化切口长度、标化疤痕面积、隐神经骸下支受损情况和膝关节功能评分。结果与纵切口组相比,横切口组的标化切口长度明显缩短,标化疤痕面积明显缩小,手术时间明显延长(P<0.05)。术后1年,与纵切口组相比,横切口组的膝关节功能评分显著增加(P<0.05)。两组隐神经骸下支受损情况比较,差异无统计学意义(P>0.05)。结论在髌腱中1/3重建前交叉韧带手术中,选用横切口取腱的方式可明显减少术后疤痕的形成,有利于膝关节功能的恢复。

Objective To study the advantages and disadvantages of different tendon incisions in anterior cruciate ligament reconstruction.Methods From January 2015 to January 2018,92 patients underwent arthroscopic reconstruction of the cruciate ligament in the middle 1/3 of the patellar tendon in jiangyan hospital of traditional Chinese medicine affiliated to nanjing university of Chinese medicine were selected.According to different surgical methods,they were divided into the transverse incision group(40 cases)and the longitudinal incision group(52 cases).The mean operation time,standardized incision length,standardized scar area,damage to the inferior branch of the skeleton of the saphenous nerve and knee function score of the two groups were compared.Results Compared with the longitudinal incision group,the length of normalized incision and area of normalized scar in the transverse incision group were significantly shorter,the operation time was significantly prolonged(P<0.05).One year after surgery,the knee function score of the transverse incision group was significantly higher than that of the longitudinal incision group(P<0.05).There was no statistically significant difference between the two groups in the damage of inferior branch of saphenous nerve(P>0.05).Conclusion In arthroscopic reconstruction of the anterior cruciate ligament in the middle 1/3 of the patellar tendon,the selection of transverse incision can significantly reduce the formation of postoperative scar and is beneficial to the recovery of knee function.