自体肌腱移植修复膝关节内侧副韧带Ⅲ度损伤  

Autogenous tendon transplantation for repair of grade Ⅲ medial collateral ligament injury

作　　者：朱威宏[1] 陈游[1] 王万春[1] 黄国良[1] 丑克[2] 陈先礼[2] 

机构地区：[1]中南大学湘雅二医院骨科,湖南省长沙市410011 [2]湖南省长沙市中心医院骨科,湖南省长沙市410007

出　　处：《中国组织工程研究》2014年第46期7463-7467,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:对于合并交叉韧带损伤的年轻且运动水平较高的患者易出现Ⅲ度膝关节内侧副韧带损伤,直接修复损伤韧带以及肌肉肌腱转位加强等传统重建方法会遗留内侧副韧带复合体松弛的情况。目的:探讨自体肌腱移植修复膝关节内侧副韧带Ⅲ度损伤的效果。方法:对Ⅲ度膝关节内侧副韧带损伤患者47例采取修复重建方法治疗,在解剖修复内侧副韧带基础上游离移植自体半腱肌腱、骨-髌韧带-骨、腘绳肌腱重建内侧副韧带浅层。结果与结论:最终37例患者得到随访,随访时间平均48个月。37例患者Lysholm评分、IKDC评分、Tegner最终随访评分、外翻应力位X射线片内侧关节间隙较健侧增宽的距离均较重建前明显改善,差异均有显著性意义(P<0.05)。按临床疗效评分为重建后优12例,良18例,中4例,差3例,优良率81%。结果证实,自体肌腱移植修复膝关节内侧副韧带Ⅲ度损伤效果良好,骨-髌韧带-骨及腘绳肌腱均是可供选择的移植物。BACKGROUND：Young patients with cruciate ligament injury and high activity levels are prone to grade III medial colateral ligament injury in knee joint. Conventional construction methods such as direct restoration of injured ligaments and muscle-tendon transposition may induce the loosening of medial colateral ligament complex. OBJECTIVE：To explore the clinical effect of autologous tendon transplantation for grade III medial colateral ligament injury of the knee joint. METHODS： Forty-seven patients with grade III medial colateral ligament rupture were treated by operative repair and reconstruction. After repairing the anatomical structure of medial colateral ligaments, we liberated organic semitendinous tendon, bone-patela tendon-bone, and hamstring tendon, to reconstruct superficial medial colateral ligament. RESULTS AND CONCLUSION：Thirty-seven patients were folowed up for 48 months. Preoperative Lysholm score, IKDC score, Tegner score at the final folow-up, and the widened medial joint space on valgus stress X-Ray films were significantly improved compared with before reconstruction （P 〈 0.05）. According to clinical efficacy scores, 12 cases achieved excelent reconstruction, 18 cases achieved good reconstruction, 4 cases achieved moderate reconstruction, and 3 cases achieved poor reconstruction. The excelent and good rate was 82%. Medial colateral ligament reconstruction based on repairing the anatomical structure is effective and satisfactory. Autologous bone-patela tendon-bone or semitendinous tendon is a good choice for medial colateral ligament reconstruction.

关 键 词：组织构建 组织工程 膝关节 内侧副韧带 重建 移植物 半腱肌腱 骨-髌韧带-骨 

分 类 号：R318[医药卫生—生物医学工程]