骨桥栓桩与界面螺钉固定前交叉韧带重建移植物胫骨端的临床价值对比

A comparative study on the clinical effect and cost of bone bridge post and interference screw for anterior cruciate ligament fixation of tibial

目的 对比骨桥栓桩与界面螺钉在膝关节前交叉韧带断裂重建术中的临床价值。方法 回顾性分析2019年7月—2020年12月我院700例在关节镜下行前交叉韧带重建手术的患者,股骨隧道均以横穿钉固定。按移植物胫骨端固定方式分为骨桥栓桩组(380例)及界面螺钉组(320例)。对比两组手术时间、切口长度、住院时间及费用;比较两组术后3个月、12个月胫骨隧道大小、膝关节功能Lyshlom评分及术后12个月关节松弛度。结果 两组患者手术时间、胫骨端切口长度、住院时间比较差异均无统计学意义(P>0.05),但骨桥栓桩组手术费用显著低于界面螺钉组(P<0.05)。术后3个月、12个月两组患者胫骨隧道大小、膝关节功能Lyshlom评分及关节松弛度比较差异均无统计学意义(P>0.05),但随着时间的延长,两组患者隧道均有不同程度的扩大(P<0.05)。结论 对于行关节镜下前交叉韧带重建术的患者,采用骨桥栓桩胫骨端固定方式可取得与界面螺钉固定相当的临床效果,但骨桥栓桩固定更具医疗经济优势,是一种可广泛推广的胫骨端固定方法。

Objective To compare the clinical efficacy and cost of bone bridge post and interference screw in the reconstruction of anterior cruciate ligament of knee.Methods 700 cases of anterior cruciate ligament reconstruction under arthroscopy were retrospectively studied.The femoral tunnel was fixed by cross nail.The patients were divided into bone bridge post group(380 cases)and interference screw group(320 cases)according to the fixation method of tibial end of graft.The operation time,incision length,hospital stay and cost were compared between the two groups,and the intraoperative conditions were evaluated.The size of tibial tunnel,Lyshlom score of knee function and joint laxity at 3 and 12 months after operation were compared between the two groups.Results There were no significant differences in operation time,tibial incision length and hospital stay between the two groups(P>0.05),but the operation cost of bone bridge post group was significantly lower than that of interference screw group(P<0.05).There were no significant differences in tibial tunnel size,Lyshlom score and joint laxity between the two groups at 3 and 12 months after operation(P>0.05),but with the extension of time,the two groups had different degrees of enlargement of the tunnel(P<0.05).Conclusion For arthroscopic anterior cruciate ligament reconstruction,tibial fixation with bone bridge post can achieve the same clinical effect as interference screw fixation,but it has more medical and economic advantages.It is a kind of tibial fixation method worthy of widespread promotion.