非辐照深冻同种异体肌腱行膝关节韧带重建的早期临床应用观察

Early clinical application of non-irradiated deep frozen tendon allograft for knee ligament reconstruction

目的比较关节镜下非辐照深冻同种异体肌腱与自体肌腱移植物重建膝关节韧带的早期疗效差异。方法自2022年2月-2022年10月于本科室行膝关节韧带重建168例,根据移植物来源不同分为观察组(非辐照深冻同种异体肌腱组)46例、对照组(自体肌腱组)128例,术后随访3个月,记录患者手术时长、术后引流量、发热天数、患肢肿胀程度、膝关节活动度及功能、术后3d及1个月感染指标及免疫排斥反应情况。结果手术时间及术后发热时长观察组均短于对照组(P<0.001),住院时间2组比较差异无统计学意义(P>0.05)。术后1个月内,膝疼痛持续>1周发生率2组比较差异均无统计学意义(P>0.05)。Lysholm评分、Larson评分、IKDC评分2组末次随访时均高于术前(P<0.05),末次随访时3项评分及膝关节活动度2组比较差异均无统计学意义(P>0.05)。结论非辐照深冻同种异体肌腱与自体肌腱重建韧带具有相似的临床效果,且免疫排斥反应率低,创伤小,手术时间短,在膝关节韧带重建手术中可作为有效、安全的移植物来源。

Objective To compare the early efficacy of knee ligament reconstruction between non-irradiated deep frozen tendon allograft under arthroscopy and autogenous tendon graft.Methods From Feb.2022 to Oct.2022,168 patients underwent knee ligament reconstruction in our department,and were divided into observation group(non-irradiated deep frozen tendon allograft,46 cases)and control group(autogenous tendon graft,128 cases)according to different sources of graft.The postoperative follow-up was 3 months.Operation duration,postoperative drainage volume,days of fever,degree of swelling of affected limb,range of motion and function of knee joint,infection index and immune rejection were recorded 3 days and 1 month after operation.Results The operation time and fever duration in the observation group were shorter than those in the control group(P<0.001),there was no significant difference in the length of hospital stay between the two groups(P>0.05).Lysholm score,Larson score and IKDC score in the two groups were higher than those before surgery at the last follow-up(P>0.05),there was no statistical significance in the three scores and knee motion between the two groups(P>0.05).Conclusions Non-irradiated deep frozen tendon allograft under arthroscopy and autogenous tendon reconstruction have similar clinical effects,and has low immune rejection rate,less trauma and short operation time,and can be used as an effective and safe source of grafts in knee ligament reconstruction surgery.