自体、同种异体肌腱重建前交叉韧带术后骨隧道扩大的对比研究  

A comparative study of tunnel enlargement after anterior cruciate ligament reconstruction with autoiogous and allogenlc tendons

作　　者：白正武[1] 张明[1] 贺业腾[1] 闫新峰[1] 

机构地区：[1]250014济南,山东大学附属千佛山医院骨科

出　　处：《中华创伤杂志》2012年第9期809-812,共4页Chinese Journal of Trauma

摘　　要：目的探讨自体胭绳肌腱、同种异体肌腱对重建前交叉韧带（anteriorcruciateliga—ment，ACL）术后骨隧道的变化和疗效差异。方法选择2008年6月-2009年11月收治的行关节镜下ACL重建术61例ACL损伤患者。根据移植物不同分为两组：同种异体肌腱重建组（A组，27例）和自体胴绳肌腱重建组（B组，34例）。术后1周、6—12个月进行MRI检查，测量矢状位骨隧道开口、开口1cm、骨隧道最宽处三点骨隧道直径，以术后1周对应部位骨隧道直径为衡量标准，对其差值进行统计学分析。采用Lysholm评分评估各组临床疗效。结果术后随访：A组平均8．4个月，B组平均8．5个月。两组患者资料术前比较差异无统计学意义。术后MRI随访发现股骨侧、胫骨侧骨隧道直径均有不同程度的增宽，其中胫骨侧较股骨侧增宽明显，两组在股骨、胫骨三个不同测量部位骨隧道增宽差异无统计学意义。所有患者关节稳定性良好。术后Lysholm评分两组比较差异无统计学意义（P〉0．05）。结论移植物不同是影响ACL重建术后骨隧道扩大的因素之一。自体肌腱、同种异体肌腱对ACL重建术后骨隧道扩大差异无统计学意义，与术后临床疗效无相关性。Objective To investigate the changes of bone tunnel and differences of clinical out- comes after anterior cruciate ligament （ACL） reconstruction with hamstring tendons from autografts and allografts. Methods The study involved in 61 patients with ACL injury undergone arthroscopic ACL reconstruction from June 2008 to November 2009. According to ACL graft differences, 61 patients were assigned to two groups, ie, Group A （ reconstruction with tendon allografis, n = 27 ） and Group B （ recon- struction with tendon autografts, n = 34）. MRI examination was performed one week and 6-12 months post-operatively to measure the sagittal bone tunnel diameters at the aperture location, at the location of 1 cm away from the aperture and at the widest location of tunnel. Taking the bone tunnel diameter at each location one week post-operatively as the measurement criteria, the differences of bone tunnel diameters at each corresponding location were analyzed statistically. Lysholm score was used to evaluate the clinical effects in the two groups. Results Group A and B were followed up for average 8.4 months and 8.5 months, respectively. Pre-operative clinical data of the two groups had no significant difference. MRI fol- low-up showed that the tunnel diameters at femoral side and tibial side both had different degree of en- largement. Meanwhile, the enlargement degree at the tibial side was larger than that at the femoral side, with no statistical differences of the two groups regarding tunnel enlargement of the three measurement lo- cations at femoral and tibial sides. Joint stability in all patients was good. The two groups showed no sig- nificant difference in Lysholm score after operation （ P 〉 0.05 ）. Conclusions Graft difference is a factor for bone tunnel enlargement after ACL surgery. Autologous and allogenic tendons show no difference in their role in bone tunnel enlargement after ACL surgery or correlation with clinical effects.

关 键 词：前交叉韧带 关节镜检查 移植 膝关节 

分 类 号：R687.4[医药卫生—骨科学]