关节镜下以同种异体跟腱重建前交叉韧带的疗效观察  

作　　者：王锟[1] 黄立新[1] 蒋定华[1] 张勇[1] 徐五 刘韦[1] 

机构地区：[1]苏州大学附属第一医院骨科,215006

出　　处：《浙江临床医学》2015年第5期709-711,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨同种异体跟腱重建前交叉韧带的近期疗效。方法2009年4月至2012年9月前交叉韧带损伤患者44例，均于关节镜下行同种异体跟腱重建前交叉韧带。术前MRJ检查示前交叉韧带损伤。术后不同时间点随访行体格检查和膝关节功能评分。结果所有患者均获得随访，随访时间24～65个月，平均38个月。术后无明显移植物排异反应。术后1例发生膝关节感染，给予抗感染治疗后痊愈。3例出现过敏反应，给予抗过敏治疗后症状改善。术后24个月所有患者前抽屉试验、Lachman试验和轴移试验均为阴性。膝关节功能评分，术后各随访时间点评分与术前比较差异有统计学意义（P〈0．05）。术后1年与术后2年评分比较差异无统计学意义（P〉0．05）。结论关节镜下行同种异体跟腱重建前交叉韧带可以恢复膝关节的稳定性．避免自体肌腱移植所引起的相关并发症，膝关节功能术后1年即恢复至正常水平．近期疗效确切。Objective To evaluate the therapeutic effects of Achilles tendon allograft used in reconstruction of anterior eruciate ligament by arthroscopy. Methods A total of 44 patients who received reconstruction of anterior cruciate ligaments at Orthopaedics, The First Affiliated hospital of Sochoow University from April 2009 to September 2012 were selected. The result of MRI revealed cruciate ligament injury. Physical examination and knee functional score were performed at pre-operation and post-operation. Physical examinations included anterior drawer test, Lachman test and pivot shift test. Knee functional score includes Lysholm knee scores sale, Tegner score, International Knee Documentation Committee （ IKDC ） . Result All patients were followed up 24-65 months, average 38 months. There was no case of immunological rejection. One case had infection of knee, curing after anti-infective therapy. Three cases had anaphylaxis, curing after anti-anaphylactic treatment. All Physical examinations were negative at 24 months after operation. Knee functional scores at post-operation were significantly improved （ P〈0.05 ） . The scores returned to normal levels at 1 year after operation. There was no significant difference between 1 year and 2 years about Knee functional scores （ p〉0.05 ） . Conclusion Reconstruction of anterior cruciate ligament with allogeneic Achilles tendon by arthroscopy can recover the stability and function of knee andavoid the complications of autografts. Function of knee can return to normal levels in 1 year after operation. The short term effect is excellent.

关 键 词：关节镜 同种异体跟腱 前交叉韧带重建 

分 类 号：R686.5[医药卫生—骨科学]