关节镜下锁扣带袢钛板TightRope固定自体腘绳肌腱的单束解剖重建前交叉韧带  

Arthroscopic Anatomic Single Bundle Anterior Cruciate Ligament Reconstruction with Tight Rope to Fix Hamstring Tendon

作　　者：蒋煜青 刘松浪 黄健 赖兵 黄映梅 JIANG Yu-qing;LIU Song-lang;HUANG Jian(Meizhou peopled hospital,Meizhou hospital affiliated to Sun Yat-sen university,Meizhou 514031)

机构地区：[1]梅州市人民医院——中山大学附属梅州医院,广东梅州514031

出　　处：《中国伤残医学》2020年第5期2-6,共5页Chinese Journal of Trauma and Disability Medicine

基　　金：梅州市市级医研类科技计划项目2016B007。

摘　　要：目的:对关节镜下自体腘绳肌腱单束解剖重建前交叉韧带(ACL)的患者,对比分析股骨骨道分别采用锁扣带袢钛板TightRope、可吸收界面螺钉2种不同固定方式的临床疗效。方法:2016年1月-2017年12月,关节镜下采用自体腘绳肌腱单束解剖重建ACL患者63例,其中股骨骨道采用TightRope固定32例(TightRope组)、可吸收界面螺钉固定31例(界面螺钉组),胫骨骨道均使用可吸收界面螺钉加门型钉固定。重建后用相同的方法进行康复锻炼。定期随访,评估各项指标进行对比,评价Tightrope与可吸收界面螺钉股骨端内固定在ACL重建中的临床效果。结果:所有患者随访9-21个月,平均13.4个月。2组重建术后膝关节最大屈曲度组间差异无显著性意义。2组末次随访彩像检查均有较高的骨道扩大发生率,但组间差异无显著性意义。与重建前比较,末次随访时TightRope组和界面螺钉组的Lysholm评分、前抽屉试验阳性率、Lachman征阳性率、轴移试验阳性率均明显改善(P<0.05),但组间差异无显著性意义(P>0.05)。结论:关节镜下应用TightRope固定自体腘绳肌腱单束解剖重建ACL可获得满意的临床疗效,与可吸收界面螺钉固定疗效相当,但其操作更简便。Objective:To compare the clinical results of Tight Rope and absorbable interface screw graft fixation at the femoral tunnel after anatomic single bundle anterior cruciate ligament reconstruction(ACL)with hamstring tendon.Methods:From January 2016 to December 2017,63 patients ACL reconstruction with hamstring autografts were studied.The femoral tunnel was fixed with Tight Rope in 32 cases(TightRope group)and absorbable interface screw fixation in 31 cases(interface Screw group),the tibial tunnel were fixed with absorbable interface screw and a portal nail.Rehabilitate with the same method after reconstruction.Follow up regularly and record the indicators,the indicators were evaluated to evaluate the clinical effect of Tightrope and absorbable interfacial screw fixation in ACL reconstruction.Results:All patients were followed up for 9-21 months with an average of 13.4 months.There was no significant difference in the maximum Knee flexion between the two groups after ACL reconstruction.The imaging examination at the last follow-up of both groups had a higher incidence of bone enlargement,but there was no significant difference between the groups.Among them,31.3%(5/16)of the patients in the Tight Rope group had a typical oval change in the inlet of femoral tunnel.Compared with pre-reconstruction,the Lysholm score,the anterior drawer test positive rate,the Lachman sign positive rate,and the pivot shift test positive rate were significantly improved in the TightRope group and the absorbable interface screw group at the last follow-up(P<0.05),but the difference between the groups was not significant.Significance(P>0.05).Conclusion:Arthroscopic anatomic single bundle ACL reconstruction with TightRope to fix hamstring tendon can achieve satisfactory clinical efficacy,comparable to the absorbable interface screw fixation,but it has the advantage of easier operation.

关 键 词：前交叉韧带 解剖重建 腘绳肌腱 TIGHTROPE 可吸收界面螺钉 骨道扩大 

分 类 号：R686[医药卫生—骨科学]