自异体肌腱移植治疗膝关节韧带损伤的临床研究  

Therapeutic effects of autologous tendon transplantation and allogeneic tendon transplantation on knee ligament injury

作　　者：王卫粮[1] 范步新[1] 张晓丽[1] 刘书茂[1] 刘新民[1] 

机构地区：[1]北京市大兴区人民医院,102600

出　　处：《河北医药》2017年第4期563-566,共4页Hebei Medical Journal

摘　　要：目的探讨自体及异体腱移植治疗膝关节韧带损伤的临床效果。方法选择2008年1月至2012年1月单侧膝关节韧带损伤的青壮年患者252例,根据患者意愿分为自体肌腱移植组及异体肌腱移植组,每组126例。2组患者分别采用自体及异体两种腱移植材料来修复患侧膝关节韧带,以健侧作为对照组。术后随访18个月,评估患者的膝关节功能(Lysholm评分、IKDL评分),并发症的发生率。结果自体肌腱移植组患者均获得随访,患侧膝关节均可达屈曲及伸直功能正常范围。自体腱移植术后动静脉损伤17例,无免疫排斥,血栓形成6例、骨筋膜室综合征并发症3例。23例患者早期出现患者肢体麻木等神经受损表现,均经治疗后消失。Lysholm评分、IKDC评分手术前后差异有统计学意义(t=3.34,4.327,P<0.05)。异体肌腱移植组患者均获得随访,患侧膝关节均可达屈曲及伸直功能正常范围。异体腱移植术后免疫排斥反应10例,血栓形成6例、骨筋膜室综合征5例、动静脉损伤10例等并发症。20例患者早期出现患者肢体麻木等神经受损表现,均经治疗后消失。Lysholm评分、IKDC评分手术前后差异有统计学意义(t=2.78,3.54,P<0.05)。2组患者对照膝关节功能评分差异无统计学意义(P>0.05);自体肌腱移植的并发症少于异体肌腱移植,但差异有统计学意义(P>0.05)。结论自体及异体腱移植术均能明显促进膝关节韧带损伤术后肢体功能的恢复。Objective To observe the therapeutic effects of autologous tendon transplantation and allogeneic tendon transplantation on knee ligament injury .Methods Two hundred and fifty-two patients with unilateral knee ligament injury who were treated from January 2008 to January 2012 were divided into autologous tendon transplantation group （ n =126 ） and allogeneic tendon transplantation （ n =126 ） according to the wishes of patients .The patients in the two groups were treated respectively by autologous or allogeneic tendon grafts to repair affected side ligament of knee joint ,at the same time, taking uninjured side ligament of knee joint as control group .The patients in both groups were followed up for 18 months to evaluate patient＇s knee joint function （Lysholm score,IKDL score） and incidence rates of complications.Results In autologous tendon transplantation group：all the patients were followed up for 18 months ,and the flexion and extension function in their affected knee joints could meet normal range .The tendon arteriovenous injuries happened in 17 patients after autologous tendon transplantation,without immunological rejection response , moreover, there were 6 cases of thrombosis and 3 cases of bone compartment syndrome .Besides 23 patients had limb numbness and other neurological damage symptoms at early stage , but these symptoms were disappeared after treatment .The preoperative Lysholm average scores were （50.8 ±6.7） points,and postoperative average scores were （86.2 ±3.5） points,there were significant differences in the scores before and after surgery （ t =3.34, P 〈0.05）.The preoperative IKDC scores were （48.2 ±5.6） points,and postoperative IKDC scores were （90.4 ±6.2） points, there were significant differences in the scores before and after surgery （ t =4.327, P 〈0.05）.In allogeneic tendon transplantation group：all the patients were followed up for 18 months,and the flexion and extension function in their affected knee joints could meet normal range .Afte

关 键 词：腱移植 早期康复 膝关节韧带损伤 韧带修复 

分 类 号：R686.5[医药卫生—骨科学]