增强自体腘绳肌腱移植物重建前交叉韧带  

Enhanced quadrupled autogenous hamstring tendon graft for anatomic single bundle reconstruction of anterior cruciate ligament

作　　者：刘训志[1] 郑天胜[1] 项卫卫[1] 何澄[1] LIU Xun-zhi;ZHENG Tian-sheng;XIANG Wei-wei;HE Cheng(Department of Orthopedics,The First Affili-ated Hospital of Gannan Medical College,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院骨科,江西赣州341000

出　　处：《中国矫形外科杂志》2020年第18期1662-1665,共4页Orthopedic Journal of China

摘　　要：[目的]评价增强自体腘绳肌腱单束等长重建前交叉韧带的临床效果。[方法]回顾性分析本院2015年1月~2018年12月,72例ACL损伤行ACL重建术的患者。其中,34例采用常规自体四股腘绳肌腱单束解剖等长重建前交叉韧带,38例采用自体腘绳肌腱联合缝线增强技术单束解剖等长重建前交叉韧带。比较两组患者应力试验、Lysholm评分和重建ACL的MRI分级。[结果]两组患者均顺利完成手术,均无严重并发症。两组患者末次随访时前抽屉试验、Lachman试验和轴移试验的稳定性均较术前显著改善(P<0.05),两组间前抽屉试验稳定性的差异无统计学意义(P>0.05),但是增加组在Lachman试验和轴移试验的稳定性显著优于常规组(P<0.05)。术后6个月和末次随访时,增强组Lysholm评分显著高于常规组(P<0.05)。末次随访的MRI检查按Rak分级标准评定,常规组优良率为79.41%,增强组优良率为97.36%,两组差异有统计学意义(P<0.05)。[结论]增强自体腘绳肌腱单束解剖重建前交叉韧带能有助于避免患者早期康复引起的韧带松弛。[Objective] To evaluate the clinical outcomes of enhanced quadrupled autogenous hamstring tendon graft for anatomic single-bundle reconstruction of anterior cruciate ligament(ACL). [Methods] From January 2015 to December 2018, 72 patients underwent anatomic single-bundle ACL reconstruction for ACL tears. Of them, 34 patients had ACL reconstruction performed with conventional hamstring tendon graft preparation, while the remaining 38 patients received the graft enhanced by the unabsorbable sutures for ACL reconstruction. The knee stabilities revealed by stress tests, Lysholm scores and MRI grades were compared between the two groups. [Results] All the patients had operation conducted successfully without serious complications. The knee stabilities showed by stress tests, including anterior drawer test, Lachman test and pivot shift test, significantly improved at the latest follow-up compared with those before operation in both groups(P<0.05). The enhanced group proved significantly superior to the conventional group in Lachman test and pivot shift test at the latest follow up(P<0.05), but no a statistical difference was noted in the anterior drawer test(P>0.05). In addition, the enhanced group got significantly higher Lysholm score than the conventional group at 6 month postoperatively and the latest follow up(P<0.05). In term of MRI evaluation, the excellent and good rate based on Rak’s criteria was of 79.41% in the conventional group, whereas 97.36% in the enhanced group, which was of statistical significance(P<0.05). [Conclusion] The enhanced quadrupled autogenous hamstring tendon graft does facilitate to relieve tension in the process of ligament healing and avoid the ligament relaxation induced by early rehabilitation exercises for anatomic single-bundle ACL reconstruction.

关 键 词：前交叉韧带 关节镜 增强技术 单束重建 

分 类 号：R687[医药卫生—骨科学]