LARS人工韧带与自体腘绳肌腱一期重建前后交叉韧带的疗效比较  

Effectiveness comparison of LARS artificial ligament and autogenous hamstring tendon in one-stage reconstruction of anterior and posterior cruciate ligaments

作　　者：李宇 张豪 肖世卓 郑秋 曾亚兰 杨洪彬 LI Yu;ZHANG Hao;XIAO Shizhuo;ZHENG Qiu;ZENG Yalan;YANG Hongbin(Department of Bone and Joint Surgery,Affiliated Hospital of Southwest Medical University,Luzhou Sichuan,646000,P.R.China;Department of Orthopedics,the First People’s Hospital of Yibin,Yibin Sichuan,644000,P.R.China;Department of Orthopedics,People’s Hospital of Linshui,Linshui Sichuan,638500,P.R.China)

机构地区：[1]西南医科大学附属医院骨与关节外科,四川泸州646000 [2]宜宾市第一人民医院骨科,四川宜宾644000 [3]邻水县人民医院骨科,四川邻水638500

出　　处：《中国修复重建外科杂志》2020年第8期1018-1024,共7页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：四川省科技厅科研基金资助项目(2013JY0103)。

摘　　要：目的比较关节镜下LARS人工韧带与自体腘绳肌腱一期重建前交叉韧带(anterior cruciate ligament,ACL)和后交叉韧带(posterior cruciate ligament,PCL)的临床疗效。方法回顾分析2013年6月—2017年6月一期重建ACL及PCL治疗的23例患者临床资料。其中,采用LARS人工韧带重建11例(人工韧带组),自体腘绳肌腱重建12例(自体肌腱组)。两组患者性别、年龄、损伤侧别、致伤原因、受伤至手术时间以及术前Lysholm评分、国际膝关节文献委员会(IKDC)评分比较,差异均无统计学意义(P>0.05)。记录并比较两组手术时间、患者术后恢复日常活动及术前运动水平时间,手术相关并发症发生情况,膝关节功能Lysholm评分及IKDC评分,以及膝关节稳定性评定结果。结果人工韧带组手术时间以及患者术后恢复日常活动、术前运动水平时间,均较自体肌腱组明显缩短(P<0.05)。两组术后切口均Ⅰ期愈合。自体肌腱组1例术后出现腓总神经损伤表现、1例肌间静脉血栓形成,两组其余患者均无并发症发生。两组患者均获随访,随访时间24~54个月,平均36.4个月。末次随访时,两组Lysholm、IKDC评分均较术前显著提高(P<0.05);两组间差异均无统计学意义(P>0.05)。两组内、外翻应力试验均为阴性;前、后抽屉试验及Lachman试验组间比较差异均无统计学意义(P>0.05)。结论关节镜下应用LARS人工韧带或自体腘绳肌腱一期重建ACL及PCL的疗效相似,均恢复了膝关节功能与稳定性,但采用前者重建的患者能够更早恢复日常活动及重返运动。Objective To compare the effectiveness of arthroscopic one-stage reconstruction of anterior cruciate ligament(ACL)and posterior cruciate ligament(PCL)with LARS artificial ligament and autogenous hamstring tendon,respectively.Methods A retrospective study was performed on 23 patients with ACL and PCL injuries,who were treated with one-stage reconstruction,between June 2013 and June 2017.The ACL and PCL were reconstructed with LARS artificial ligament in 11 patients(artificial ligament group)and autogenous hamstring tendon in 12 patients(autogenous tendon group).There was no significant difference in gender,age,side of injury,cause of injury,time from injury to operation,and preoperative Lysholm score and International Knee Documentation Committee(IKDC)score between the two groups(P>0.05).The operation time,the time of recovery of daily activities and preoperative exercise level,the occurrence of surgical-related complications,Lysholm score,IKDC score,and the results of knee stability assessment were recorded and compared between the two groups.Results The operation time and the time of recovery of daily activities and preoperative exercise level were significantly shorter in artificial ligament group than in autogenous tendon group(P<0.05).All incisions healed primarily.In autogenous tendon group,the common fibular nerve injury occurred in 1 case and intermuscular vein thrombosis occurred in 1 case.No complication occurred in the remaining patients of the two groups.All the patients were followed up 24-54 months(mean,36.4 months).At last follow-up,the Lysholm score and IKDC score of the two groups were significantly higher than preoperative scores(P<0.05).There was no significant difference between the two groups(P>0.05).The varus and valgus stress tests of the two groups were negative.There was no significant difference in anterior drawer test,posterior drawer test,and Lachman test between the two groups(P>0.05).Conclusion The effectiveness of arthroscopic one-stage reconstruction of ACL and PCL with LARS artific

关 键 词：关节镜 LARS人工韧带 自体腘绳肌腱 前交叉韧带 后交叉韧带 关节功能重建 

分 类 号：R687.4[医药卫生—骨科学]