关节镜下应用同种异体髌腱重建前交叉韧带的疗效分析  

Effect of arthroscopic anterior cruciate ligaments reconstruction with allogeneic patellar tendon

作　　者：谢峰[1] 杨柳[1] 郭林[1] 代灿[1] 王晓宇[1] 韩雪松[1] 欧阳云飞[1] 

机构地区：[1]第三军医大学西南医院关节外科中心,重庆400038

出　　处：《重庆医学》2007年第7期616-617,620,共3页Chongqing medicine

摘　　要：目的探讨关节镜下应用同种异体髌腱(骨-腱-骨组织,B-PT-B)重建膝关节前交叉韧带(anterior cruciate ligament,ACL)的方法及临床疗效。方法2003年2月～2006年5月对87例前交叉韧带损伤的患者在关节镜下利用挤压界面螺钉固定,深低温冷冻异体B-PT-B重建前交叉韧带。按照国际膝关节评分委员会(IKDC)、Lysholm和Tegnar膝关节评分标准评价疗效。结果所有患者术后获6～42个月(平均20个月)随访。术后无伸膝受限,最后随访时屈膝活动度为120°～135°(平均130.16°)。Lysholm膝关节功能评分术前为49～78分,平均为(68.7±5.4)分,终末随访时为86～96分,平均为(92.7±3.3)分,手术前后的差异有统计学意义(P<0.01)。Tegnar运动能力评价表在初次受伤前为4～9分,平均为(7.1±1.5)分;伤后术前为0～3分,平均为(2.4±0.7)分;随访结束时为3～9分,平均为(5.9±1.7)分。受伤前和随访结束时评分差异无统计学意义(P>0.05)。终末随访IKDC评分:A 27例(31.0%),B 51例(58.6%),C 9例(10.3%)。87例患者中,69例恢复伤前运动水平,18例运动水平较伤前减低。结论关节镜下同种异体髌腱重建前交叉韧带手术操作精细、创伤小,术后膝关节功能恢复满意。Objective To evaluate the therapeutic effect of reconstruction anterior cruciate ligament （ACL） using allogeneic patellar tendon under arthroscopy. Methods From February 2003 to May 2006 , 87 cases of ruptured ACL were fixated with compressed screws and reconstructed under arthroscopy with deep-frozen BPTB allograft. The clinical results were evaluated according to IKDC, Lysholm, and Tegner clinical rating scales. Results All patients were followed up for 6 -42 months （average 20 months）. At the last follow-up, there was no knee extension limitation and knee flexion was between 120°and 135°,with an average of 130.16°. The Lysholm score of the 87 cases was 68. 7±5.4 before operation , and 92.7±3. 3 at the last follow up. Statistically, the difference between the two Lysholm scores was significant （P〈0. 01）. The average Tegner activity score decreased in patients from 7. 1 ±1. 5 （range, 4 to 9） before injury to 5.9±1. 7 （range, 3 to 9） at follow-up, but no significance（P〈 0.05）. At termination of follow-up, IKDC score, was graded as A in 27 cases （31.0%）, B in 51 cases （58.6%）, and C in 9 case （10.3°）. Of the 87 patients, 69 patients returned to the same sports level before injury and 18 were under the level. Conclusion Arthroscopic reconstruction of ACL with allogeneic patellar tendon has the advantage of minimal trauma in surgery and reliable satisfactory outcome.

关 键 词：关节镜 前交叉韧带 移植 髌腱 

分 类 号：R687.2[医药卫生—骨科学]