膝关节镜下自体腘绳肌腱和同种异体肌腱移植重建前交叉韧带对比观察  

Comparative study on reconstruction of anterior cruciate ligaments with allografts and hamstring tendon under arthroscopy

作　　者：刘红光[1] 陈述祥[1] 赵崇达[1] 丁林坚[1] 司徒坚[1] 

机构地区：[1]暨南大学医学院第六附属医院江门市五邑中医院,广东江门529031

出　　处：《中国骨伤》2008年第4期267-269,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨关节镜下同种异体肌腱和自体腘绳肌腱重建前交叉韧带的疗效。方法:收集32例前交叉韧带损伤病例,单纯前交叉韧带(ACL)损伤29例,与后交叉韧带(PCL)同时损伤3例。分为2组,同种异体肌腱重建15例,男12例,女3例,年龄23～61岁;自体腘绳肌腱重建17例,男11例,女6例,年龄17～57岁。用可吸收或钛挤压螺钉固定,观察并记录治疗后的症状、体征变化和Lysholm评分以及术后6个月的功能康复情况。结果:全部病例均获得随访,时间6～8个月,所有病例无膝前区疼痛,临床症状消失,膝关节功能得到改善。同种异体肌腱重建前交叉韧带5例患者仍出现Lachman征阳性体征,其中1例产生严重的排斥反应,关节镜复查韧带完全吸收。2组患者治疗后Lysholm评分分别为平均(88.5±7.2)分和(93.2±8.5)分,差异无统计学意义(P>0.05)。结论:关节镜下两种方法重建前交叉韧带都有较好的疗效,同种异体肌腱重建交叉韧带早期有更多的症状,有明显的个体差异,重建交叉韧带尽可能选用自体腘绳肌腱。Objective：To evaluate the effect of reconstruction of anterior cruciate ligaments（ACL） with allogeneic tendon or autologous hamstring tendon under arthroscopy. Methods：Thirty-two cases of ACL injury（3 cases compound with PCL inju-ry） were reviewed. All the patients were divided into two groups randomly. Fifteen cases were reconstructed with hamstring tendon,including 12 male and 3 female with the age ranging from 23 to 61 years. Seventeen cases were reconstructed with allograft,including 11 male and 6 female with the age ranging from 17 to 57 years. The tendons were fixed with absorbable or Ti screws. All patients were recorded symptoms,physical signs and Lysholm Scores two weeks after operation,and functional rehabilitation of knee six months after operation. Results：All cases were followed up from 6 to 8 months. Pain and clinical symptoms disappeared and the function of knee joint was improved in all patients. Five patients of allograft with positive Lachman test result,one with severe graft rejection was found complete absorption of allograft under arthroscopy. No significant differences were seen in Lysholm Score between the two groups,average（88.5±7.2）,（93.2±8.5） after operation（P〉0.05）. Conclusion：The effects of reconstruction of cruciate ligaments with allogeneic tendon or autologous hamstring tendon under arthroscopy are more satisfying. But there are more symptoms and obvious individual differences in the earlier stage of rehabilitation. So reconstruction of cruciate ligaments under arthroscopy using autologous hamstring tendon should be performed as far as possible.

关 键 词：关节镜 前交叉韧带 修复外科手术 临床对照试验 

分 类 号：R622.2[医药卫生—整形外科] R686.5[医药卫生—外科学]