取腓骨长肌腱和腘绳肌腱重建前交叉韧带的短期疗效对比研究  

A case study of comparing the clinical effects of anterior cruciate ligament reconstruction using peroneus longus tendon or hamstring tendon

作　　者：马进宁[1] 刘勇 王涛 高禄鑫 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]武警宁夏总队医院,宁夏银川750004

出　　处：《宁夏医学杂志》2016年第8期710-712,共3页Ningxia Medical Journal

摘　　要：目的 总结应用腓骨长肌（PLT）和腘绳肌腱（HT）分别移植重建前交叉韧带的临床疗效。方法 将38例确诊为膝关节前交叉韧带断裂的患者随机分为2组,分别行PLT和HT重建前交叉韧带,其中PLT组14例,HT组24例。手术前后分别应用国际膝关节文献委员会膝关节评估表（IKDC评分）、Lysholm膝关节评分对患者运动功能进行主观评价,术后采用Lachman试验、ADT试验、大腿周径差值及关节活动度进行客观指标评价。结果 所有患者均得到5~28个月的随访,平均17.16个月。PLT组Lysholm评分由术前的（44.64±20.21）分提高至（93.00±3.82）分,IKDC评分评分由术前的（54.43±9.34）分提高至（92.14±5.07）分;HT组Lysholm评分由术前的（44.13±20.11）分提高至（93.96±4.91）分,IKDC评分评分由术前的（53.86±11.05）分提高至（91.46±3.88）分,2组手术前后比较均有统计学意义（P〈0.05）;PLT组发生1例Ⅰ度松弛,HT组发生3例Ⅰ度松弛、1例Ⅱ度松弛。结论 PLT组与HT组取得了相同的治疗效果及患者满意度,但PLT组较HT组出现更少的膝关节周围并发症,不良反应少,早期疗效可靠,可作为采用取自体腘绳肌腱重建前交叉韧带手术的一种有效补充方法。Objective To compare the clinical effects of using peroneus longus tendon （PLT） and hamstring tendon （HT） to reconstruct anterior cruciate ligament （ACL）. Methods 38 patients with knee anterior cruciate ligament rupture were randomly divided into two groups for anterior cruciate ligament reconstruction. One group with 14 patients was reconstructed PLT, while the other group containing 24 patients were used HT. The International Knee Documentation Committee （IKDC） subjective knee evaluation form was em- ployed to determine the knee function before and after the operation. Tegner Lysholm Knee Scoring Scale was used for subjective evalua- tion of movement activities. In addition, Lachman test, anterior drawer test （ADT）, thigh circumference difference and joint mobility were applied for valuation after the operation. Results All cases were followed up for 5 months to 28 months with a mean period of 17.16 months. The Lysholm scale score of PLT group was improved from 44.64 ±20.21 （ before surgery） to 93.00±3.82 （ after surgery）. IKDC scores of PLT group were raised from 54.43± 9.34 （ before surgery） to 92.14 ± 5.07 （ after surgery）. Lysholm scale score of the HT group was elevated from 44.13 ± 20.11 （ before surgery） to 93.96± 4.91 （ after surgery）, while IKDC score from 53.86± 11.05 to 91.46 ± 3.88. There was significant improvement of knee function before and after the operation in both of the two groups. However, there was one patient in PLT group occurred I degree of relaxation and three patients occulted I degree of relaxation and one patient occurred Ⅱ degree of relaxation in HT group. Conclusions Both PLT and HT group have achieved the similar therapeutic effect and the patients＇ satisfaction. However, comparing with the HT group,the PLT group appears less complication and side effect around the knee joint and has reliable curative effect in the early stage. Therefore, PLT could be used as an effective complementary method for the anterior cruciate ligame

关 键 词：前交叉韧带 腓骨长肌腱 腘绳肌腱 关节镜 重建 

分 类 号：R687.2[医药卫生—骨科学]