走出人工韧带重建前交叉韧带的历史误区——总结中国成功经验  

Walk out of the historical misunderstanding of artificial ligament used for anterior cruciate ligament reconstruction--sum up China's successful experience

作　　者：陈天午 陈世益[1,2] Chen Tianwu;Chen Shiyi(Institute of Sports Medicine,Fudan University,Shanghai 200040,China;Department of Sports Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学运动医学研究所,上海200040 [2]复旦大学附属华山医院运动医学科,上海200040

出　　处：《中国医学前沿杂志（电子版）》2020年第9期1-7,共7页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家自然科学基金项目(81572108);上海市扬帆计划(19YF1414600)。

摘　　要：采用人工韧带的前交叉韧带重建术(anterior cruciate ligament reconstruction,ACLR)在过去半个世纪中经历了“兴起-衰落-再兴起”的曲折过程。随着人们对ACLR和重返运动理论的不断探究,临床医生对采用人工韧带重建前交叉韧带的若干历史问题与成功经验有了深入认识。基于大量临床证据,新型人工韧带用于ACLR的失败率并不高于采用自体移植物或同种异体移植物的同类手术,术后滑膜炎仅为“偶发”不良事件。没有证据表明人工韧带材料寿命直接导致失效或断裂。人工韧带手术成功与以下4项要素有关:理解人工韧带材料自身特点、采用等长或类等长重建技术、保留天然前交叉韧带残端、规范早期运动康复。Anterior cruciate ligament reconstruction(ACLR)with artificial ligaments has undergone a tortuous process of"risedecline-revive"over the past half century.With the investigation on the theory of ACLR and return to sports,clinicians have gained a deep understanding of some historical issues and successful experience in using artificial ligament in anterior cruciate ligament(ACL)surgery.Based on a large number of clinical evidence,the failure rate of new artificial ligaments for ACLR is no higher than that of same procedure using autografts or allografts.For postoperative synovitis,it is only an"occasional"adverse event.There is no evidence that material lifespan directly leads to failure or rupture of artificial ligaments.The success of artificial ligament surgery is related to the following four elements:understanding the characteristics of artificial ligament material,using isometric or nearlyisometric reconstruction techniques,preserving natural ACL residues,and regulating early sports rehabilitation.

关 键 词：前交叉韧带重建术 人工韧带 误区 成功经验 

分 类 号：R687.4[医药卫生—骨科学]