自体髌腱与γ射线照射同种异体髌腱重建前交叉韧带的前瞻性比较研究  

A PROSPECTIVE STUDY ON ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH PATELLAR TENDON AUTOGRAFT VERSUS Gamma IRRADIATED ALLOGRAFT

作　　者：田少奇[1] 张积华[2] 王妍 孙康[1] 夏长所[1] 于腾波[1] 张才龙[1] 

机构地区：[1]青岛大学医学院附属医院关节外科,青岛266003 [2]青岛大学医学院附属医院查体中心,青岛266003 [3]青岛市妇女儿童医院妇产科

出　　处：《中国修复重建外科杂志》2010年第3期282-286,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：山东省自然科学基金重点项目(Z2008C10)~~

摘　　要：目的前瞻性对比研究自体髌腱与经γ射线照射的同种异体髌腱重建前交叉韧带(anterior cruciate ligament,ACL)的稳定性及临床疗效。方法2004年1月-2007年10月,收治69例ACL腱部断裂患者。根据采用移植物不同将患者随机分为两组:自体髌腱组(A组)36例,γ射线照射的同种异体髌腱组(B组)33例。A组:男30例,女6例;平均年龄30.1岁。运动伤28例,交通伤5例,其他伤3例。受伤至手术时间平均1.4个月。单纯ACL腱部断裂30例,合并内侧副韧带损伤6例。B组:男26例,女7例;平均年龄32.5岁。运动伤27例,交通伤4例,其他伤2例。受伤至手术时间平均1.5个月。单纯ACL腱部断裂27例,合并内侧副韧带损伤6例。两组一般资料比较差异均无统计学意义(P>0.05),具有可比性。两组均由同一组医师采用标准关节镜技术完成ACL重建。通过术后一般情况、轴移试验、Lachman试验、Daniel单腿水平跳跃试验、国际膝关节文献委员会(IKDC)评分、Lysholm与Tegner运动水平评分及KT-2000关节测量仪检测比较临床疗效。结果术后患者均获随访,A组平均随访时间39.5个月,B组37.6个月。A组发生术中髌骨骨折1例、术后髌前痛2例;B组无并发症发生。A、B组住院时间分别为(15.6±2.4)d及(15.5±1.5)d,差异无统计学意义(P>0.05);A组手术时间为(89.5±10.5)min,较B组(59.5±8.5)min延长,但术后发热时间(4.7±1.6)d较B组(9.5±2.5)d缩短,差异均有统计学意义(P<0.05)。末次随访时A、B组间Lachman试验及轴移试验比较,差异均有统计学意义(P<0.05);组内手术前后比较,差异均有统计学意义(P<0.05)。A、B组间Daniel单腿水平跳跃试验、IKDC评分、Lysholm评分及Tegner评分的差异均无统计学意义(P>0.05),但B组功能与运动水平评分有下降趋势;组内手术前后比较,差异均有统计学意义(P<0.05)。末次随访时KT-2000关节测量仪检测A、B组健患侧差异分别为(2.4±0.6)mm及(5.5±3.6)mm,比较差异有统计学�Objective To analyze the stabil ity and cl inical outcomes of arthroscopic anterior cruciate l igament （ACL） reconstruction with γ irradiated patellar tendon allograft compared with autograft. Methods From January 2004 to October 2007, 69 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into two groups： group A （autograft, n=36） and group B （γ irradiated allograft, n=33）. In group A, there were 30 males and 6 females with an average age of 30.1 years, including 30 cases of simple ACL rupture and 6 cases of ACL rupture with medial accessory l igament injury; ACL rupture was caused by sports in 28 cases, by traffic accident in 5 cases, and by others in 3 cases; and the time from injury to operation was 1.4 months on average. In group B, there were 26 males and 7 females with an average age of 32.5 years, including 27 cases of simple ACL rupture and 6 cases of ACL rupture with medial accessory l igament injury; ACL rupture was caused by sports in 27 cases, by traffic accident in 4 cases, and by others in 2 cases; and the time from injury to operation was 1.5 months on average. There were no significant differences in general data between two groups （P 〉 0.05）. The same arthroscopic technique was used in all ACL reconstructions done by the same surgeon. The cl inical outcome was evaluated and compared by general conditions, pivot shift test, Lachman test, KT-2000 arthrometer testing, Daniel＇s one-leg hop test, International Knee Documental Committee （IKDC） scoring, Lysholm knee scoring scale, and Tegner activity score. Results All patients were followed up for 39.5 months （group A） and 37.6 months （group B）. In group A, patella fracture occurred in 1 case and anterior knee pain in 2 cases postoperatively. No compl ication occurred in group B. The hospital ization times in groups A and B were （15.6 ± 2.4） days and （15.5 ± 1.5） days, respectively, showing no significant difference （P 〉 0.05）. The operation time of group

关 键 词：前交叉韧带 白体髌腱 同种异体髌腱 Γ射线 重建 

分 类 号：R687.2[医药卫生—骨科学]