镜下自体梋绳肌与同种异体半腱肌重建膝前交叉韧带对比研究  

Comparison of Reconstruction of Anterior Cruciate Ligament Using Quadruple Hamstring Tendon Aurograft and Homologous Semitendinosus under Arthroscope

作　　者：卢启贵[1] 王平[1] 黄东红[1] 孙克民[1] 李政[1] 郑英慧[1] 

机构地区：[1]广东省深圳平乐骨伤科医院,广东深圳518010

出　　处：《实用骨科杂志》2013年第8期709-712,共4页Journal of Practical Orthopaedics

摘　　要：目的观察关节镜下自体梋绳肌肌腱与同种异体半腱肌腱单骨道重建膝关节前交叉韧带(anterior cruciateligament,ACL)的疗效与差异。方法选择2009年10月至2010年11月膝关节前交叉韧带单骨道重建患者115例,分为两组。A组:自体梋绳肌肌腱移植57例,获随访49例,男40例,女9例;年龄16～54岁,平均28.8岁。B组:同种异体半腱肌腱移植58例,获随访52例,男44例,女8例;年龄12～50岁,平均27.9岁。根据骨骺闭合时间,大于21岁自体梋绳肌肌腱组50例、同种异体半腱肌腱组47例,股骨端均采用Rigidfix系统固定;小于21岁自体梋绳肌肌腱组7例、同种异体半腱肌组11例,股骨端采用Endobutton系统固定;胫骨端均采用生物挤压螺钉加自制门型钉悬吊固定。评价项目包括手术时间、发热人数、膝关节活动度、国际膝关节评分委员会评分、Lysholm评分及KT2 000测定。结果 101例患者均获随访,随访时间15～31个月,平均22.4个月。两组患者术后膝关节稳定性均得到明显改善,除手术时间、发热人数外,物理检查及功能评分差异均无统计学意义(P>0.05)。结论关节镜下自体与同种异体肌腱重建ACL都有较好的疗效,移植肌腱的选择需根据患者的伤情及自身要求来确定。Objective To investigate the efficacy of anterior cruciate ligament reconstruction with single bone tunnel under arthroscope using Quadruple hamstring tendon autograft and Homologous Semitendinosus. Methods 115 patients with injury of anterior cruciate ligament （ACL） were devided into two groups：quadruple hamstring tendon aurograft group and homolo- gous semitendinosus group. According to the epiphyseal line clossing time, the patients over 22 ages were fixed with Rigidfix system and patients under 22 ages were fixed with endobutton in the femeral side. They were fixed with bioabsorbable interference screw and selfmade ligment staple in the tibial side. Operation time, fever, ROM, IKDC scoring system, Lysholm scoring system for knee function, and KT 2 000 mesurement were observed. Results The anterior stability was recovered significantly in both groups. There were no differences in physical examination and scoring system between the both groups. Conclusion Good therapeutic effect can be found in both groups. The choice of the tendon grafting shoud be made according to injury and individual need.

关 键 词：关节镜 自体梋绳肌肌腱 同种异体半腱肌肌腱 前交叉韧带 

分 类 号：R622.2[医药卫生—整形外科]