KD-Ⅲ-M型膝关节损伤中自体腘绳肌腱及LARS人工韧带重建后交叉韧带的比较研究  

Comparative study on posterior cruciate ligament reconstruction with autologous hamstring tendon and LARS artificial ligament in the treatment of KD-Ⅲ-M knee dislocation

作　　者：徐立虎[1,2] 靳佳欣 刘众成 姜金[1] 王红[1] 夏亚一[1,2] 吴萌[1,2] XU Li-hu;JIN Jia-xin;LIU Zhong-cheng;JIANG Jin;WANG Hong;XIA Ya-yi;WU Meng(The 1st Department of Orthopaedices,Lanzhou University Second Hospital,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州大学第二医院骨一科,甘肃兰州730030 [2]兰州大学第二临床医学院,甘肃兰州730030

出　　处：《中国骨伤》2021年第12期1103-1107,共5页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金(编号:82060405);中央高校基本科研业务费专项基金(编号:lzujbky-2019-sp04);兰州大学第二医院萃英科技创新计划(编号:CY2018-QN17)。

摘　　要：目的:观察KD-Ⅲ-M型膝关节损伤患者中内侧副韧带Ⅲ度损伤患者Ⅰ期重建前后交叉韧带及内侧副韧带修补手术的疗效,比较关节镜下自体腘绳肌腱重建前交叉韧带并有限切开行内侧副韧带修补手术的基础上LARS人工韧带和自体对侧腘绳肌腱重建后交叉韧带的手术时间、手术并发症、住院费用及术后疗效等。方法:2016年3月至2019年1月符合该研究标准的患者36例,分为两组。A组20例,男17例,女3例,年龄(34.7±9.2)岁,选用自体腘绳肌重建前后交叉韧带,内侧副韧带原位修补;B组16例,男15例,女1例,年龄(36.8±8.6)岁,选用LARS人工韧带重建后交叉韧带,自体同侧腘绳肌腱重建前交叉韧带,内侧副韧带原位修补。比较两组患者的手术时间、手术并发症、住院时间、住院费用。两组患者手术前后膝关节功能分别用美国特种外科医院(Hospital for Sepcial Surgery,HSS)评分及Lysholm评分评价,组内及组间进行疗效比较。结果:两组患者均无感染及切口愈合不良等并发症发生。A组手术时间(120.25±9.55) min,B组(106.63±8.85) min,两组比较差异有统计学意义(P<0.01);A组患者住院时间(10.60±1.64) d,B组住院时间(10.38±1.59) d,两组比较差异无统计学意义(P>0.05);经术后不小于1年的随访,HSS评分A组由术前(32.95±5.03)分提高至术后(84.70±5.72)分(P<0.01),B组由术前(33.81±4.10)分提高至术后(85.00±5.25)分(P<0.01);Lyshlom评分,A组术前(21.10±3.46)分提高至术后(80.25±5.75)分(P<0.01),B组由术前(21.56±3.01)分提高至术后(80.00±4.30)分(P<0.01);两组患者组间术前术后评分差异均无统计学意义(P>0.05)。结论:自体腘绳肌重建前后交叉韧带,内侧副韧带原位修补较LARS人工韧带重建后交叉韧带,自体同侧腘绳肌腱重建前交叉韧带,内侧副韧带原位修补的手术时间明显增加,后者住院费用高于前者,两组疗效无明显差异。Objective:To observe the curative effect of one-stage reconstruction of anterior cruciate ligament(ACL) posterior cruciate ligament(PCL) and medial collateral ligament(MCL) in patients with KD-Ⅲ-M knee injury,and to compare the operation time,hospitalization cost and curative effect after arthroscopic reconstruction of PCL with LARS artificial ligament and autogenous hamstring tendon,ACL reconstruction with autogenous hamstring tendon and MCL repair combined with limited incision.Methods:From March 2016 to January 2019,a total of 36 patients met the criteria of this study.Twenty patients in group A were treated with autogenous hamstring tendon reconstruction of ACL and PCL and repair of MCL,including 17 males and 3 females,with an average age of(34.7±9.2) years old.Sixteen patients in group B with LARS artificial ligament reconstruction of PCL,with an autogenous hamstring tendon reconstruction of PCL and MCL repair as before as group B including 15 males and 1 female,with an average age of(36.8±8.6) years old.The operation time,hospitalization time and total hospitalization cost were compared between the two groups.The preoperative and postoperative functions of the two groups were evaluated by Hospital for Sepcial Surgery(HSS) score and Lysholm score respectively,and the curative effects were compared within and between groups.Results:All the patients in the two groups were followed up for at least 1 year.There were no complications such as infection and poor wound healing in both groups.There was significant difference in operation time between(120.25±9.55) min in group A and(106.63±8.85) min in group B(P<0.01).The average hospitalization days in group A was(10.60±1.64) days,while that in group B was(10.38±1.59) days.There was no significant difference between the two groups(P>0.05).The HSS score of group A increased from preoperative 3 2.95±5.03 to postoperative 84.70±5.72(P<0.01),and that of group B increased from preoperative 33.81±4.10 to postoperative 85.00±5.25(P<0.01).The Lyshlom score in gro

关 键 词：腘绳肌腱 前交叉韧带 后交叉韧带 内侧副韧带 膝 

分 类 号：R684[医药卫生—骨科学]