关节镜下单、双束同种异体肌腱重建前交叉韧带的疗效比较  

EFFECTIVENESS COMPARISON OF DOUBLE-BUNDLE AND SINGLE-BUNDLE ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH DEEP-FROZEN ALLOGRAFTS

作　　者：朱超华[1] 陈百成[1] 孙然[1] 刘虎[1] 王智慧[1] 谢磊[1] 

机构地区：[1]河北医科大学第三医院关节骨科,石家庄050051

出　　处：《中国修复重建外科杂志》2011年第8期916-920,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的比较研究关节镜下单、双束同种异体肌腱重建前交叉韧带(anterior cruciate ligament,ACL)的临床疗效。方法将2008年1月-2009年1月符合选择标准的105例ACL损伤患者,根据重建方法不同随机分为单束重建组(n=59)及双束重建组(n=46),移植物均采用同种异体深低温冻存肌腱。于术后6、12、24个月进行随访,共93例患者完成随访,其中单束重建组51例,双束重建组42例。两组患者性别、年龄、身高、体重、病程、合并伤等一般资料比较,差异均无统计学意义(P>0.05),具有可比性;两组患者术前国际膝关节文献委员会(IKDC)评分以及Lysholm评分差异均无统计学意义(P>0.05),前抽屉试验、Lachman试验均为阳性(+),轴移试验均为Ⅱ度阳性(++)。结果两组患者术后切口均为Ⅰ期愈合,无骨折、感染、下肢深静脉血栓形成等并发症发生。术后6、12个月,两组IKDC评分及Lysholm评分比较,差异均无统计学意义(P>0.05);术后12个月,两组Lachman试验、前抽屉试验及轴移试验结果比较,差异无统计学意义(P>0.05);术后24个月,除前抽屉试验外,双束重建组IKDC评分、Lysholm评分、轴移试验和Lach-man试验以及KT-1000检测双膝前后位移差值均优于单束重建组,差异有统计学意义(P<0.05)。结论双束同种异体深低温冻存肌腱重建ACL的临床效果优于单束重建。Objective To compare the effectiveness between arthroscopic double-bundle and single-bundle anterior cruciate ligament （ACL） reconstruction with deep-frozen allografts. Methods Between January 2008 and lanuary 2009, 105 patients undergoing arthroscopic ACL reconstruction with deep-frozen allografts were selected and randomly divided into single-bundle （n=59） or double-bundle （n=46） groups. Patients were evaluated preoperatively and postoperatively 6, 12, and 24 months. Of the patients, 93 （51 in the single-bundle group and 42 in the double-bundle group） were available for full evaluation. There was no significant difference in gender, age, height, weight, disease duration, complication, the International Knee Documentation Committee （IKDC） score, and Lysholm score between 2 groups （P 〉 0.05）. The anterior drawer test and the Lachman test for all were rated as ＋ in 2 groups, and the pivot shift test were rated as ＋＋ before operation. Results All wounds healed by first intention, and no related complication such as fracture, infection, or deep venous thrombosis was observed. There was no significant difference in the IKDC score, Lysholm score, anterior drawer test, pivot shift test, and Lachman test between 2 groups at 6-month and 12-month follow-up （P 〉 0.05）. The IKDC score, Lysholm score, pivot shift test, Lachman test, and the side-to-side difference measured by KT-1000 arthrometer in the double-bundle group were significantly better than those in single-bundle group at 24-month follow-up （P 〈 0.05）. Conclusion The double-bundle ACL reconstruction with deep-frozen allografts has better effectiveness than the single-bundle ACL reconstruction.

关 键 词：前交叉韧带 同种异体肌腱 单束重建 双束重建 关节镜 

分 类 号：R687.2[医药卫生—骨科学]