关节镜下同种异体骨-髌腱-骨重建前交叉韧带的临床疗效  

Arthroscopic anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft

作　　者：徐琦[1] 杨柳[1] 郭林[1] 戴刚[1] 段小军[1] 陈光兴[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：《第三军医大学学报》2009年第5期441-443,共3页Journal of Third Military Medical University

摘　　要：目的评价关节镜下应用同种异体骨一髌腱一骨重建膝关节前交叉韧带的临床疗效。方法2005年12月至2007年12月，我科住院患者经关节镜检查证实为前交叉韧带（anterior cruciate ligament，ACL）断裂者125例，获得随访的患者109例，所有患者均于关节镜下行同种异体骨-髌腱-骨重建膝关节前交叉韧带术。疗效评估采用：KT1000，Lysholm，Irrgang，改良larson，国际膝关节评分委员会（international knee documentation committee，IKDC）韧带评分系统。结果所有患者术后随访6～24个月，平均16．9个月，所有患者随访时异体移植物位置良好，术后所有患者KT-1000检查双侧膝关节前向松弛度差值〈3mm，IKDC评分活动水平正常或接近正常98例（89．9％），Lysholm评分从（50．2±4．3）分提高至（88．4±6．4）分，Irrgang评分从（43．4±4．3）分提高至（82．6±5．3）分，Larson评分从（41．4±4．8）分提高至（88．5±4．3）分，和术前相比均有显著性意义（P〈0．01）。所有患者均无严重并发症发生。结论同种异体移植物是前交叉韧带重建良好的选择之一，关节镜下同种异体骨，髌腱一骨移植物重建前交叉韧带手术能使膝关节功能获得良好的恢复。Objective To observe the clinical outcome of arthroscopic anterior cruciate ligament （ACL） reconstruction with bone-patellar tendon-bone （B-PT-B） allograft. Methods Totally 125 patients with ACL ruptures received ACL reconstruction with B-PT-B allograft between December 2005 and December 2007, and 109 were followed up. Clinical outcome was evaluated according to International Knee Documentation Committee （IKDC） , Lysholm knee, Irgang and modified Larson scores. Results The patients were followed up for 6 to 24 months （mean 16.9 months）. All grafts for reconstruction were in good position according to X-ray image during the fellow-up period. The KT-1000 maximal manual side-to-side difference was less than 3 mm in all patients. By the time of latest follow-up, IKDC scores in 98 patients （89.9%） were normal or nearly normal. The average Lysholm score was improved from preoperative 50.2 ± 4.3 to postoperative 88.4 ± 6.4, Irgang score from43.4 ±4.3 to 82.6 ±5.3, modified Larson score from41.4 ±4.8 to 88.5 ±4.3. Conclusion The B-PT-B allograft is alternative graft for ACL reconstruction. Arthroscopie ACL reconstruction with B-PT-B allograft achieves satisfactory clinical outcomes.

关 键 词：关节镜 前交叉韧带重建 骨骨-髌腱-骨 同种异体移植物 

分 类 号：R616[医药卫生—外科学] R686.5[医药卫生—临床医学]