关节镜下膝交叉韧带重建中自体与异体肌腱移植物的疗效比较  

Anterior and posterior cruciate ligament reconstruction under arthroscopy: tendon autografts versus allografts

作　　者：杨松杰[1] 张清旭 陈绪彪[1] 林晓旭 邱雪立[1] 

机构地区：[1]汕头市中心医院骨科,广东省汕头市515031

出　　处：《中国组织工程研究》2017年第34期5513-5518,共6页Chinese Journal of Tissue Engineering Research

基　　金：2012年汕头市科技计划项目(E201200538)~~

摘　　要：背景:国内多数研究表明异体与自体肌腱重建交叉韧带的疗效相近,均是良好的移植物,近期疗效满意。目的:比较自体与异体肌腱移植物在关节镜下膝交叉韧带重建中的临床疗效。方法:将100例膝关节交叉韧带断裂患者随机分2组,每组50例,均在关节镜下进行交叉韧带重建手术,自体肌腱组移植物采用自体肌腱,异体肌腱组移植物采用同种异体肌腱。比较两组患者治疗前和出院时的关节稳定性及活动度;出院后1,3,6,9个月,随访观察两组肌力恢复程度、Werner髌股痛评分及Lysholm评分。结果与结论:①关节稳定性:两组出院时的的Lachman试验阳性率、轴移试验阳性率均较治疗前明显改善(P<0.05);出院时,两组Lachman试验阳性率、轴移试验阳性率比较差异均无显著性意义;②关节活动度:治疗后,两组关节伸直活动度、屈曲活动度比较差异均无显著性意义;③随访情况:两组治疗后不同时间点的肌力恢复程度、Werner髌股痛评分及Lysholm评分均较治疗明显改善(P<0.05);出院后1,3,6,9个月,两组间各指标比较差异均无显著性意义;④结果表明:自体与异体肌腱移植物在关节镜下膝交叉韧带重建中均能够明显改善患者关节稳定性和活动度,具有较好的近期临床疗效。BACKGROUND： Most domestic studies have shown that there are similar curative effects of allogeneic andautogenous tendons in anterior or posterior cruciate ligament reconstruction. Both of them are good grafts thatcan achieve satisfactory outcomes.OBJECTIVE： To compare the clinical efficacies of allogeneic and autogenous tendons in anterior and posterior cruciate ligamentsreconstruction under arthroscopy.METHODS： A total of 100 patients with knee cruciate ligament rupture undergoing anterior and posterior cruciate ligamentreconstruction under arthroscopy were enrolled in this study, and randomly divided into two groups （n=50 per group）： autogenoustendon group and allogeneic tendon group. The joint stability and mobility of the two groups were compared before operation and atdischarge. The muscle strength recovery, Werner patellofemoral pain score and the Lysholm score of the two groups were evaluatedand compared at 1, 3, 6, 9 months after discharge.RESULTS AND CONCLUSION： （1） Joint stability： The Lachman test positive rates and axial shift test positive rates in the two groupsafter operation were significantly better than the baseline （P 〈 0.05）. At discharge, there were no significant differences in Lachmantest positive rates and axial shift test positive rates between the two groups. （2） Joint range of motion： There were no significantdifferences in the joint ranges of extension and flexion between the two groups after operation. （3） Follow-up visit： Muscle strength, theWerner patellar pain scores and the Lysholm scores in the two groups were significantly improved at discharge （P 〈 0.05）, but therewere no significant difference between the two groups at 1, 3, 6, 9 months after discharge. In summary, autologous hamstring tendonand allogeneic tendon have the same clinical therapeutic effects in anterior and posterior cruciate ligament reconstruction underarthroscopy, both of which can achieve good short-term outcomes.

关 键 词：移植物 关节镜 骨-髌韧带-骨组织移植重建术 组织工程 生物材料 材料相容性 自体肌腱移植物 异体肌腱移植物 膝交叉韧带 膝交叉韧带重建 疗效 

分 类 号：R318[医药卫生—生物医学工程]