自体肌腱单束重建前交叉韧带股骨端Endobutton固定与Rigidfix固定的临床对照研究  

Endobutton fixation versus Rigidfix fixation of the femoral end of the reconstructed anterior cruciate ligament with single bundle of autogenous tendon

作　　者：郑秋 张豪 肖世卓 李宇 杨洪彬 ZHENG Qiu;ZHANG Hao;XIAO Shizhuo;LI Yu;YANG Hongbin(Department of Bone and Joint Surgery,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Orthopedics,People’s Hospital of Linshui County,Guang’an 638500,China)

机构地区：[1]西南医科大学附属医院骨与关节外科,泸州646000 [2]邻水县人民医院骨科,638500

出　　处：《国际骨科学杂志》2020年第6期365-370,共6页International Journal of Orthopaedics

基　　金：四川省科技厅科研基金资助项目(2013JY0103)。

摘　　要：目的对比分析膝关节镜下自体肌腱单束重建前交叉韧带术中分别采用Endobutton带袢钢板与Rigidfix横穿钉固定股骨端肌腱的临床疗效。方法回顾性分析2017年3月至2019年3月西南医科大学附属医院骨科收治的78例自体肌腱单束重建前交叉韧带术中股骨端采用Endobutton带袢钢板或Rigidfix横穿钉固定患者的临床资料,其中采用Endobutton带袢钢板固定38例(E组),采用Rigidfix横穿钉固定40例(R组)。采用Lysholm膝关节评分评估患者手术前后膝关节功能,并通过三维CT重建计算手术后股骨隧道宽度变化,进行前抽屉试验(ADT试验)、Lachman试验评估术后膝关节稳定性。结果 E组患者平均随访时间为24个月(13~33个月),R组患者平均随访时间为23个月(13~34个月)。末次随访时,E组Lysholm膝关节评分为(91.4±2.01)分,R组为(90.45±1.88)分,与术前[分别为(40.21±2.90)分、(41.35±2.78)分]差异有统计学意义(P<0.05),两组间比较无统计学意义(P>0.05)。末次随访时,E组股骨端隧道内口增宽(0.80±0.16)cm,隧道中点增宽(0.70±0.19)cm,R组股骨端隧道内口增宽(0.75±0.21)cm,隧道中点增宽(0.65±0.15)cm,两组间股骨端隧道内口及隧道中点增加宽度差异无统计学意义(P>0.05)。E组ADT试验Ⅰ度松弛8例,Ⅱ度松弛1例;Lachman试验Ⅰ度松弛6例,Ⅱ度松弛1例。R组ADT试验Ⅰ度松弛10例;Lachman试验Ⅰ度松弛5例,Ⅱ度松弛1例。两组ADT试验及Lachman试验差异均无统计学意义(P>0.05)。结论自体肌腱单束重建前交叉韧带术中股骨端Endobutton固定与Rigidfix固定均可取得满意固定效果,术后膝关节功能均能获得良好改善。Objective To investigate the tendon fixation results with Endobutton plate versus Rigidfix transverse nail during the reconstruction of anterior cruciate ligament with autogenous tendon under arthroscopy.Methods A retrospective analysis of 78 patients who were admitted to the department of orthopedics of the Affiliated Hospital of Southwest Medical University from March 2017 to March 2019 to undergo single-bundle autologous tendon reconstruction of the anterior cruciate ligament were performed.The femoral end of the reconstructed tendons were either fixed with Endobutton loop plate or Rigidfix cross nail.Among them,38 cases were fixed with Endobutton tapered steel plate(group E),and 40 cases were fixed with Rigidfix cross nails(group R).The Lysholm knee scores were used to evaluate the knee joint function before and after the operation.The width of the femoral tunnel after the operation was calculated in the three-dimensional CT reconstruction.The anterior drawer test(ADT)and Lachman test were performed to evaluate the postoperative stability of the knee joints.Results The average follow-up in the group E was 24 months(13 to 33 months),and 23 months(13 to 34 months)in the group R.At the last follow-up,the Lysholm knee scores in the group E were(91.4±2.01)points,and(90.45±1.88)points in the group R,without statistical significance between both groups(P>0.05).However,the Lysholm knee scores in either group at the last follow-up were significantly lower than those before operation[group E(40.21±2.90)points,group R(41.35±2.78)points](both P<0.05).At the last follow-up,the femoral tunnel in the group E was(0.80±0.16)cm wide at the internal opening and(0.70±0.19)cm at the midpoint.The femoral tunnel in the group R was(0.75±0.21)cm wide at the internal opening and widened(0.65±0.15)cm at the midpoint.There was no significant difference either in the width of the internal opening or the width at the midpoint of the tunnel between both groups(both P>0.05).According to the results of ADT test in the group E,there w

关 键 词：关节镜 前交叉韧带重建 Endobutton固定 Rigidfix固定 隧道增宽 

分 类 号：R68[医药卫生—骨科学]