自体与深低温冷冻异体髌腱重建前交叉韧带临床疗效比较研究  

A Retrospective Study of the Anterior Cruciate Ligament Reconstruction Using Patella Tendon:Allograft Versus Autograft

作　　者：徐志宏[1] 陈东阳[1] 蒋青[1] 孙旭[1] 

机构地区：[1]南京市鼓楼医院关节疾病诊治中心,南京210008

出　　处：《中国运动医学杂志》2008年第3期280-282,293,共4页Chinese Journal of Sports Medicine

摘　　要：目的：回顾性观察比较自体与深低温冷冻同种异体骨腱骨（BPTB）组织重建膝关节前交叉韧带（ACL）临床疗效差异。方法：回顾2003年8月-2005年12月共82例ACL损伤患者,其中自体同侧BPTB组织移植59例,同种异体BPTB移植23例。术前、术后行体格检查、膝关节IKDC评定、Lysholm-Tegner评分、VAS疼痛评分及KT-2000检测。采用t检验及χ2检验比较两组间差异。结果：41例自体及17例异体移植物重建患者分别获得平均34.3个月（18-46个月）和平均33.5个月（19-43个月）的最终随访。异体组发生再断裂1例,无感染及排斥反应。自体组4例无明显跪地痛,其余37例患者均极少或未尝试跪地动作,其中髌前取骨处明显压痛5例。5例自体及1例异体移植患者随访时前抽屉试验（ADT）阳性,3例自体及1例异体称植患者Lachman检查阳性。术后两组间关节活动度、膝关节IKDC评定、Lysholm-Tegner评分、KT-2000检测均无显著差异,VAS评分有显著差异（P〈0.05）。结论：同种异体与自体髌腱移植物重建ACL临床疗效相近,同种异体移植组织是重建ACL的良好替代物。Objective To compare the clinical outcomes of anterior cruciate ligament（ACL）reconstruction by using allograft and autograft of patella tendon. Methods From August 2003 to December 2005,82 ACL reconstruction patients were studied retrospectively,including 59 cases using autograft of patellar bone-tendon-bone （BPTB）and 23 cases using BPTB allograft. Physical examination, scores of IKDC,Lysholm-Tegner and VAS as well as KT-2000 measurements were used for evaluation preand post-operation. Results 41 autograft and 17 allograft patients were finally followed up. One allograft patient suffered re-rupture of the reconstructed ligament. Positive ADT test were found in 5 autograft and 1 allograft patients and positive Lachman test were found in 3 autograft and 1 allograft patients. No statistically significant differences were revealed in ROM. IKDC,Lysholm- Tegner Score and KT-2000 measurements showed no significant differences between two groups, but VAS for au- tograft group were significantly higher than allograft group（P〈0.05）. Conclusion ACL reconstruction with allograft and autograft achieved similar clinical outcomes. Allograft could be a reasonable choice for ACL reconstruction.

关 键 词：髌腱 自体组织 同种异体组织 重建 前交叉韧带 

分 类 号：R687[医药卫生—骨科学]