关节镜下同种异体BPTB双束重建膝关节ACL的有效性与安全性评价  

Evaluation on effect and safety of Arthroscopic Double-bundle ACL Reconstruction Using allograft BPTB

作　　者：张富运[1] 马伟涛[1] ZHANG Fu-yun(Department of Orthopedics, The Second People＇s Hospital of Jiaozuo, Henan, 45400, Chin)

机构地区：[1]焦作市第二人民医院骨科,河南454000

出　　处：《社区医学杂志》2017年第22期4-7,共4页Journal Of Community Medicine

摘　　要：目的探讨关节镜下同种异体骨-髌腱-骨(Bone-patellar tendon-bone,BPTB)双束重建膝关节前交叉韧带(Anterior cruciate ligament,ACL)的效果。方法选取2014年1月—2016年12月收治的实施BPTB重建ACL手术的患者81例,将其分为3组:A组(27例)行同种异体BPTB双束重建;B组(29例)行同种异体BPTB单束重建;C组(25例)行自体BPTB单束重建。全部患者随访时间6~24个月,观察早期排斥反应,通过膝关节查体,IKDC、Lysholm、Tegner评分,KT-2000检查等评估疗效。计量资料比较采用单因素方差分析,两两比较采用LSD-t检验;计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果三组术后骨桥蛋白、血沉值、C反应蛋白,早期患膝疼痛、关节积液、白细胞升高发生率比较差异均无统计学意义(均P>0.05);三组术后6个月Lysholmy评分、Tegner评分、IKDC评分比较差异均无统计学意义(均P>0.05);三组常规KT-2000 30°、90°及后推KT-2000 90°位比较差异均无统计学意义(均P>0.05);后推KT-2000 30°位的关节前移度A组[(0.57±0.32)]小于B组、C组[(1.02±0.52)、(1.12±0.44)](均P<0.05);Pivot shift阳性率A组(3.70%)低于B组、C组[(27.59%)、(28.00%)](均P<0.05);膝前痛发生率A组、B组[(7.41%)、(10.34%)]均低于C组(76.00%)(均P<0.05)。结论同种异体BPTB与自体BPTB早期排斥反应无明显差异,同种异体BPTB双束重建ACL能够更好地恢复膝关节整体前向及旋转稳定性,减少并发症。Objective To investigate the effect of arthroscopic double-bundle reconstruction of anterior cruciate ligament（ACL） with allogeneic bone-patellar tendon-bone（BPTB）.Methods A total of 81 patients undergoing BPTB reconstruction of ACL surgery from January 2014 to December 2016 were selected and divided into three groups：group A（27 cases） accepting allogeneic BPTB double-bundle,group B（29 cases） accepting allogeneic BPTB single bundle,group C（25 cases） accepting autologous BPTB single bundle reconstruction.All patients were followed up for 6 to 24 months.The early rejection was observed and evaluated by knee examination,IKDC,Lysholm,Tegner score and KT-2000 examinations.Measurement data were analyzed by one-way ANOVA and LSD-t test.Count data were analyzed by χ~2 test.P〈0.05 for the difference was statistically significant.Results There was no significant difference in the incidence of osteopontin,ESR,C-reactive protein,early knee pain,joint effusion and leukocytosis among the three groups（all P〈0.05）.There was no significant difference in Lysholmy score,Tegner score and IKDC score between the three groups at 6 months after operation（all P〈0.05）.There was no signif icant difference of conventional KT-2000 30°,90°and KT-200090°post-push between three groups（all P〈0.05）.Joint movement of push KT-2000 30°in group A[（0.57＋0.32）]was less than the group B and group C[（1.02＋0.52）,（1.12＋0.44）]（all P〈0.05）.The positive rate of Pivot shift in group A（3.70%）was significantly lower than that in group B and group C[（27.59%）,（28%）]（all P〈0.05）.The incidence rates of anterior knee pain in group A and group B[（7.41%）,（10.34%）]were lower than that in group C（76%）（all P〈0.05）.Conclusions There was no signif icant difference in the early rejection between allogeneic BPTB and autologous BPTB.Allograft BPTB double bundle reconstruction of ACL can better restore the overall forward and rotational stability of the knee joint and redu

关 键 词：前交叉韧带 双束重建 同种异体骨-髌腱-骨 自体骨-髌腱-骨 

分 类 号：R684[医药卫生—骨科学]