LARS与自体骨-髌腱-骨重建膝关节前交叉韧带急性损伤的疗效比较  

A COMPARISON OF EFFECTIVENESS BETWEEN LIGAMENT ADVANCED REINFORCEMENT SYSTEM AND BONE-PATELLAR TENDON-BONE AUTOGRAFT FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

作　　者：李业成[1,2] 张巍[3] 吴勇[1] 王洪俊[1] 康龙[1] 胡绵虎[1] 陈根元[2] 朱宝林[1] 

机构地区：[1]沭阳县人民医院,骨科江苏沭阳,223600 [2]兰州大学第一医院骨科 [3]沭阳县人民医院检验科,江苏沭阳223600

出　　处：《中国修复重建外科杂志》2012年第9期1045-1050,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的比较LARS(ligament advanced reinforcement system)与自体骨-髌腱-骨(bone-patellar tendon-bone,BPTB)移植重建膝关节前交叉韧带(anterior cruciate ligament,ACL)的疗效。方法将2007年7月-2011年7月收治并符合选择标准的50例单膝ACL损伤患者,根据重建韧带材料不同随机分为两组。关节镜下24例采用LARS重建(LARS组),26例采用BPTB重建(BPTB组)。两组患者性别、年龄、受伤至手术时间及致伤原因等一般资料比较,差异均无统计学意义(P>0.05),具有可比性。术后两组采用相同方法行膝关节功能锻炼。结果术后两组患者切口均Ⅰ期愈合。患者均获随访,随访时间2～3年。Lachman试验、前抽屉试验和轴移试验均为阴性。两组各1例发生股骨、胫骨螺钉松动;BPTB组2例、LARS组1例发生膝关节疼痛。LARS组术后2、6个月时Lysholm评分及Tegner评分均显著高于BPTB组(P<0.05),术后12、24个月时差异无统计学意义(P>0.05)。两组术后各时间点国际膝关节评分委员会(IKDC)评分比较,差异均无统计学意义(P>0.05)。KT-1000测定两组术后各时间点胫骨前移距离比较,差异均有统计学意义(P<0.05)。结论与自体BPTB相比,LARS重建ACL手术创伤小、术后早期膝关节功能恢复快,但远期疗效相似。Objective To compare the effectiveness of anterior cruciate ligament（ACL） reconstruction betweenthe ligament advanced reinforcement system（LARS） and bone-patellar tendon-bone（BPTB） autograft.Methods BetweenJuly 2007 and July 2011,50 cases（50 knees） of ACL injury were treated with LARS in 24 cases（LARS group） and with BPTBin 26 cases（BPTB group）,respectively.There was no significant diff erence in age,gender,time from injury to surgery,andinjury reason between BPTB group and LARS group（P〈0.05）.The postoperative rehabilitation protocol was performed in 2groups.Results All incisions healed at the first stage.All patients were followed up 2-3 years.The results of Lachman test,anterior drawer test,and pivot shift test were negative.Screw loosening in femur and tibia occurred in 1 case of each grouprespectively,anterior knee pain in 2 cases of BPTB group and in 1 case of LARS group.The Lysholm and Tegner scores weresignificantly higher in LARS group than in BPTB group at 2 and 6 months after operation（P〉0.05）;but no significant diff erencewas found between 2 groups at 12 and 24 months（P〉0.05）.The IKDC scores showed no significant diff erence between 2 groupsat diff erent time points after operation（P〉0.05）.During follow up,KT-1000 arthrometer and knee stability showed significantdiff erences in antedisplacements of the tibia between 2 groups at all time points after operation（P〉0.05）.Conclusion LARShas less trauma and earlier functional recovery than BPTB autograft for ACL reconstruction,but the long-term effectiveness issimilar.

关 键 词：前交叉韧带损伤 LARS 自体骨-髌腱-骨 韧带重建 

分 类 号：R687.2[医药卫生—骨科学]