不同移植物重建前交叉韧带疗效比较  

A Compare Study of the Anterior Cruciate Ligament Reconstruction with Different Grafts

作　　者：张其亮[1] 滕学仁[1] 

机构地区：[1]青岛市市立医院(东院区)骨科,青岛266071

出　　处：《中国运动医学杂志》2011年第6期523-527,522,共6页Chinese Journal of Sports Medicine

摘　　要：目的:比较分别采用自体骨-髌腱-骨(BPB)、四股腘绳肌腱、异体骨-髌腱-骨关节镜下重建膝关节前交叉韧带的临床疗效。方法:选择2006年1月至2010年1月期间获得完整随访的单纯前交叉韧带损伤患者159例,按照移植物不同分为3组:自体腘绳肌腱组、自体骨-髌腱-骨组和异体骨-髌腱-骨组。回顾性分析三组患者术前、术后一般情况,膝关节活动度(ROM)、膝关节稳定性、Lysholm评分及IKDC评分。结果:三组手术前后各项指标有显著差异(P<0.05);术后膝关节活动度(ROM)、膝关节稳定性、Lysholm评分及IKDC评分三组之间未见明显差异(P>0.05);自体骨-髌腱-骨组髌前疼痛发生率为13.89%,显著高于自体腘绳肌腱组和异体骨-髌腱-骨组(P<0.05);异体骨-髌腱-骨组术后需行关节穿刺病例的比率显著高于自体腘绳肌腱组和自体骨-髌腱-骨组(P<0.05),异体骨-髌腱-骨组有1例发生严重感染。结论:三种方法重建前交叉韧带的近期疗效相近,均可以作为前交叉韧带重建选择的移植物;若考虑患者髌前疼痛及感染等情况,自体腘绳肌腱移植物有优势。三种移植物重建前交叉韧带的远期效果还有待进一步研究。Objective To compare the clinical outcome of anterior cruciate ligament（ACL） reconstruction with autografts of patellar bone tendon bone,quadrupled hamstring tendons and allograft of patellar bone tendon bone.Methods 159 patients with single ACL injury from January 2006 to January 2010 in our hospital were chosen as subjects.Patients were divided into three groups based on different grafts used：hamstring tendons（Group A）,autografts of patellar bone tendon bone（Group B）,and allograft of patellar bone tendon bone group（Group C）.The basic condition,the stability and ROM of the knee joint,Lysholm and IKDC score were analyzed retrospectively before and after operation.Results All indicators of three groups showed significantly difference before and after operation.There were no difference among three groups in the stability and ROM of the knee joint,Lysholm and IKDC score.The incidence of anterior knee pain in group B was 13.89%,higher than both group A and C.The ratio of the patients who needed joint puncture in group C was higher than both group A and B.One patient had serious infection in the autografts group.Conclusion All the above three grafts could be used in ACL reconstruction and the clinical outcomes were satisfactory.Consider the incidence of anterior knee pain and infection,hamstring tendons had more advantage.The long-term effect of three grafts should be further observed.

关 键 词：前交叉韧带重建 骨-髌腱-骨 腘绳肌腱 异体移植 

分 类 号：R687.2[医药卫生—骨科学]