先进人工韧带加强系统人工韧带与自体骨-髌腱-骨重建膝前交叉韧带的早期临床疗效比较  

Anterior cruciate ligament reconstruction with ligament advanced reinforcement system artificial ligament and autogenous bone-patellar tendon-bone:a comparison of early clinical outcomes

作　　者：袁拥军[1] 何国础[2] 岑建平[1] 张振庆[1] 孙长惠[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院骨科,200020 [2]上海交通大学医学院附属瑞金医院骨科

出　　处：《上海医学》2009年第7期598-601,共4页Shanghai Medical Journal

摘　　要：目的前瞻性对照研究先进韧带加强系统(LARS)人工韧带与自体骨-髌腱-骨(B-PT-B)重建前交叉韧带(ACL)手术的早期临床疗效。方法收集2005年5月—2007年1月上海交通大学医学院附属瑞金医院卢湾分院收治的ACL损伤患者41例。根据LARS韧带的使用指征和患者自愿的原则,分别选择LARS人工韧带(LARS组,18例)或自体B-PT-B(BPTB组,23例)作为重建ACL的移植物,并在术前及术后3、6、12个月进行Lysholm、HSS(改良)、Tegner膝关节评分。结果LARS组驻拐下地时间、弃拐行走时间以及恢复运动的时间分别为(3.0±0.3)d、(20.1±0.8)d和(3.0±0.2)个月,均显著短于BPTB组的(6.9±0.3)d、(35.1±2.1)d和(6.1±0.4)个月(P值均<0.05)。LARS组术后3个月Lysholm评分、Tegner评分和HSS评分即均较术前显著改善(P值均<0.05),而BPTB组术后6个月才较术前显著改善(P值均<0.05),两组术后12个月恢复均较理想。LARS组术后3、6个月时的Lysholm评分、Tegner评分和HSS评分均显著高于BPTB组(P值均<0.05);术后12个月两组间的差异无统计学意义(P值均>0.05)。结论LARS人工韧带较自体B-PT-B的手术创伤小,韧带强度高,更适合于关节镜下操作,患者术后膝关节功能恢复更快。Objective To compare the early clinical outcomes of anterior cruciate ligament （ACL） reconstruction between ligament advanced reinforcement system （LARS） artifical ligaments and autogenous bone- patellar tendon-bone（B-PT-B）. Methods Forty-one patients with ACL injury, who were treated in our hospital during May 2005 to January 2007, were included in the present study. Eighteen patients were treated with LARS artificial ligaments and 23 were treated with autogenous B-PT-B according to the indications of LARS ligament reconstruction and patient＇s willingness. Each patient was evaluated with Lysholm score, modified HSS score, Tegner score preoperatively, and 3, 6, 12 months postoperatively. Results The crutch walking time, non-crutch walking time, and movement recovery time in patients of LARS group were （3.0 ± 0.3） d, （20. 1± 0.8） d and （3.0 ± 0.2） months, respectively, significantly shorter than those of BPTB group E （6.9 ±0.3） d, （35.1± 2.1 ） d and （6.1±0.4） months, respectively （P〈0,05）]. The Lysholm score, Tegner score, and HSS score in the LARS group were significantly improved 3 months after operation compared with before operation （P〈0.05） ） and those in the BPTB group were significantly improved 6 months after operation （P〈0.05）. Patients recovered well in both groups 12 months after operation. The 3 scores in LARS group were significantly higher than those of BPTB group 3 and 6 months after operation （ P〈0.05）, and there were no significant differences between the 2 groups 12 months after operation. Conclusion LARS has less trauma than BPTB; it has strong ligaments and is suitable for management under arthroscopy, and the patients recover earlier. （Shanghai Med J, 2009, 32： 598-601）

关 键 词：先进人工韧带加强系统 人工韧带 前交叉韧带 重建 

分 类 号：R687.2[医药卫生—骨科学]