前交叉韧带重建术后移植物成熟度与膝关节功能的相关性研究  

Correlation between graft maturity and knee function after anterior cruciate ligament reconstruction

作　　者：陈荣进 顾心怡 向先祥[2] CHEN Rongjin;GU Xinyi;XIANG Xianxiang(Emergency Department of Orthopedics,the Affiliated Chengdu Fifth Peopled Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu Sichuan,611130,P.R.China;Department of Sports Medicine,Affiliated Zhongshan Hospital of Dalian University,Dalian Liaoning,116001,P.R.China)

机构地区：[1]成都中医药大学附属第五人民医院急诊骨外科,成都611130 [2]大连大学附属中山医院运动医学科,辽宁大连116001

出　　处：《中国修复重建外科杂志》2021年第6期704-709,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨前交叉韧带(anterior cruciate ligament,ACL)重建术后移植物成熟度与膝关节功能的相关性。方法以2016年8月—2018年8月接受自体肌腱ACL重建术的50例患者作为研究对象,其中男28例,女22例;年龄18~50岁,平均31.0岁。术后6个月、2年行MRI检查并测量移植物胫骨端与股骨端信噪比(signal to noise quotient,SNQ),取两端均值作为移植物SNQ值;采用Tegner评分、Lysholm评分、国际膝关节文献委员会(IKDC)评分评价膝关节功能。统计分析术后各时间点移植物胫骨端及股骨端SNQ值差异,术后6个月移植物SNQ值与术后2年膝关节功能评分相关性;同时根据术后6个月移植物SNQ值将患者分为A组(SNQ值≥12)及B组(SNQ值<12),进一步分析SNQ值与膝关节功能评分相关性。结果术后切口均Ⅰ期愈合,无感染及血管神经损伤发生。患者均获随访,随访时间24~28个月,平均26.6个月。术后6个月及2年膝关节IKDC评分、Lysholm评分、Tegner评分均较术前增加,且术后2年高于术后6个月,差异均有统计学意义(P<0.05)。术后6个月及2年移植物SNQ值分别为12.517±6.272、10.900±6.012,差异有统计学意义(t=1.838,P=0.007)。其中,术后6个月移植物胫骨端、股骨端SNQ值与术后2年对应部位SNQ值比较,同时间点移植物胫骨端与股骨端SNQ值比较,差异均有统计学意义(P<0.05)。50例患者术后6个月SNQ值与术后2年Lysholm评分、IKDC评分、Tegner评分均成负相关(r=–0.965,P=0.000;r=–0.896,P=0.000;r=–0.475,P=0.003)。患者根据SNQ值分为A、B组,各25例;两组术后6个月SNQ值与术后2年Lysholm评分、IKDC评分、Tegner评分亦均成负相关(P<0.05)。结论 ACL重建术后患者膝关节功能评分和移植物成熟度均逐渐提高,早期SNQ值越低,后期膝关节功能评分越高,通过术后早期SNQ值可预估患者后期膝关节功能。Objective To investigate the correlation between graft maturity and knee function after anterior cruciate ligament(ACL) reconstruction. Methods A total of 50 patients who underwent ACL reconstruction with autologous tendons between August 2016 and August 2018 were included in the study. There were 28 males and 22 females, with an average age of 31.0 years(range, 18-50 years). At 6 months and 2 years after operation, the signal to noise quotient(SNQ) values of tibial and femoral ends of graft were measured by MRI, and the mean value was taken as the SNQ value of graft. The function of knee joint was evaluated by Tegner, Lysholm, and International Knee Documentation Committee(IKDC) scores. The differences in SNQ values between tibial and femoral ends were analyzed at 6 months and2 years after operation. The correlation between SNQ value at 6 months after operation and knee function score at 2 years after operation was analyzed. According to SNQ value at 6 months after operation, the patients were divided into group A(SNQ value≥12) and group B(SNQ value<12) and the correlation between SNQ value and knee function score was further analyzed. Results All incisions healed primarily without infection or injury of blood vessels and nerves. All patients were followed up 24-28 months(mean, 26.6 months). The IKDC, Lysholm, and Tegner scores at 6 months and 2 years after operation were significantly higher than those before operation(P<0.05), and all scores at 2 years after operation were also significantly higher than those at 6 months(P<0.05). The SNQ values at 6 months and 2 years after operation were12.517±6.272 and 10.900±6.012, respectively, and the difference was significant(t=1.838, P=0.007). The SNQ values of graft at 6 months after operation were significantly different from those at 2 years after operation(P<0.05), and the SNQ values of tibial and femoral ends of graft at the same time point were significantly different(P<0.05). The SNQ value of 50 patients at 6 months after operation was negatively correlated

关 键 词：膝关节 前交叉韧带 韧带重建 移植物成熟度 关节功能 相关性研究 

分 类 号：R687.4[医药卫生—骨科学]