MRI评价自体骨-髌韧带-骨与股四头肌腱行前交叉韧带重建后移植物成熟度及膝关节的功能  

MRI evaluation of graft maturity and knee function after anterior cruciate ligament reconstruction with autogenous bone-patellar tendon-bone and quadriceps tendon

作　　者：杨匡洋[1] 王昌兵[1] Yang Kuangyang;Wang Changbing(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong Province,China)

机构地区：[1]佛山市中医院,广东省佛山市528000

出　　处：《中国组织工程研究》2022年第6期963-968,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:前交叉韧带重建术中一般采用自体骨-髌韧带-骨、股四头肌腱或腘绳肌肌腱作为移植物,其中关节内移植物的成熟度是前交叉韧带重建后恢复患者运动的关键。目的:分析使用自体骨-髌韧带-骨与自体股四头肌腱行前交叉韧带重建后的移植物成熟度及患者膝关节功能差异。方法:选择2018年6月至2020年1月在佛山市中医院行前交叉韧带重建术的患者60例,其中男50例,女10例,年龄17-42岁,韧带重建使用自体骨-髌韧带-骨移植物者27例,使用自体股四头肌腱移植物者33例。韧带重建后3,6,12个月,比较两组移植物股骨端、中段、胫骨端3个区域的MRI信噪比;比较两组患者国际膝关节评分委员会膝关节评估量表(IKDC)评分、Lysholm主观评分及双侧膝关节KT-1000差值;对比两组患者韧带重建后12个月的膝关节步态差异。研究获得佛山市中医院医学伦理委员会批准,批准号:2018003。结果与结论:(1)韧带重建后3,6,12个月,两组间移植物股骨端、中段的MRI信噪比比较差异无显著性意义(P>0.05),股四头肌腱组移植物胫骨端MRI信噪比高于骨-髌韧带-骨组(P>0.05);(2)韧带重建后3,6,12个月,两组间的IKDC评分Lysholm主观评分及双侧膝关节KT-1000差值比较差异无显著性意义(P>0.05);(3)韧带重建后12个月,两组患者膝关节步态分析比较差异无显著性意义(P>0.05);(4)结果表明,使用自体骨-髌韧带-骨移植物行前交叉韧带重建后的移植物成熟度优于自体股四头肌腱,但成熟度不同并不影响患者韧带重建后的功能恢复。BACKGROUND:Anterior cruciate ligament reconstruction usually uses bone-patellar tendon-bone,quadriceps tendon or hamstring tendon as grafts.The maturity of the intra-articular graft is the key to patient’s movement recovery after the anterior cruciate ligament reconstruction.OBJECTIVE:To analyze the potential differences associated with graft maturity between bone-patellar tendon-bone and quadriceps tendon autografts after anterior cruciate ligament reconstruction.METHODS:Sixty patients undergoing anterior cruciate ligament reconstruction in Foshan Hospital of Traditional Chinese Medicine from June 2018 to January 2020 were selected,including 50 males and 10 females,at the age of 17-42 years old.Twenty-seven patients were in the autologous bone-patellar tendonbone group,and 33 patients were in the quadriceps tendon group.At 3,6 and 12 months after ligament reconstruction,the signal/noise quotient of the three regions of the femoral side,the middle and the tibial side of the graft were compared between the two groups.The international knee documentation committee knee evaluation form,Lysholm score,and bilateral KT-1000 difference at 3,6,and 12 months after surgery were compared between the two groups.The differences of knee gait were compared between the two groups at 12 months after ligament reconstruction.This study was approved by the Ethics Committee of Foshan Hospital of Traditional Chinese Medicine(approval No.2018003).RESULTS AND CONCLUSION:(1)At 3,6,and 12 months after ligament reconstruction,there was no significant difference in the signal/noise quotient values at 3,6 and 12 months after the operation of the femoral side and the middle segment(P>0.05).The signal/noise quotient was higher in the quadriceps tendon group than that in the bone-patellar tendon-bone group(P>0.05).(2)At 3,6 and 12 months after ligament reconstruction,there were no statistically significant differences in knee IKDC,Lysholm score,and KT-1000 between the two groups(P>0.05).(3)There were no statistically significant differences i

关 键 词：骨-髌韧带-骨 股四头肌腱 前交叉韧带 膝关节 信噪比 成熟度 自体肌腱 MRI 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]