关节镜下全内TightRope固定和界面挤压螺钉固定自体月国绳肌腱重建前交叉韧带的临床对比研究  

Clinical Comparison of Arthroscopic Total Internal Tightrope Fixation and Interface Compression Screw Fixation with Autologous Hamstring Tendon for Anterior Cruciate Ligament Reconstruction

作　　者：闫宇旺 杨泽宇 刘国亭 陈兰芳 曹志斌 孙宏武 贾岩波[2] YAN Yuwang;YANG Zeyu;LIU Guoting;CHEN Lanfang;CAO Zhibin;SUN Hongwu;JIA Yanbo(Sport Medicine,Third Hospital of Baotou City,Baotou 014040 China;Sports medical center of the Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000 China)

机构地区：[1]包头市第三医院创伤运动医学科,内蒙古包头014040 [2]内蒙古医科大学第二附属医院运动医学中心,呼和浩特010000

出　　处：《内蒙古医学杂志》2022年第11期1320-1323,1327,共5页Inner Mongolia Medical Journal

摘　　要：目的比较分析自体月国绳肌腱重建前交叉韧带过程中胫骨端采用关节镜下全内TightRope(可调节锁扣带袢钢板)和界面挤压螺钉固定两种不同固定方式的差异。方法选择收治的32例膝关节前交叉韧带损伤患者在关节镜下进行重建。根据重建时胫骨端固定方法的不同,分为A组和B组。A组16例,采用关节镜下全内技术,股骨侧和胫骨侧均采用TightRope固定;B组16例,胫骨侧采用界面挤压螺钉固定,股骨侧纽扣钢板固定。术后正规功能锻炼,定期随访,各项指标进行比较。结果在手术时间、取腱切口长度、胫骨骨道骨量丢失、肌腱移植物的直径和长度方面,A组和B组的各项指标差异有统计学意义,A组优于B组。两组病例术后膝关节Lysholm评分均较术前明显升高,两组间术后膝关节Lysholm评分比较差异无统计学意义。结论关节镜下全内技术股骨侧和胫骨侧均采用TightRope固定,和应用界面挤压螺钉固定胫骨侧及纽扣钢板固定股骨侧两种不同固定方式重建膝关节前交叉韧带,通过6~24个月随访,效果满意。采用关节镜下全内技术TightRope双侧悬吊固定手术操作不复杂,胫骨侧骨道骨量丢失少,节省肌腱,节省手术时间,手术适应症广,可用于骨质疏松的患者,值得临床推广应用。Objective To compare and analyze the differences of two different fixation methods of tibial end with arthroscopic total internal Tightrope(adjustable buckle loop plate)and interface extrusion screw in the process of autologous hamstring tendon reconstruction of anterior cruciate ligament(ACL).Methods 32 patients with anterior cruciate ligament(ACL)injury of knee were reconstructed under arthroscopy.According to the different fixation methods of tibial end during reconstruction,they were divided into group A and group B.In group A,16 cases were fixed with interface compression screw on the tibial side and button plate on the femoral side;16 cases in group B were treated with arthroscopic total internal fixation,and Tightrope was used for femoral and tibial fixation.After operation,regular functional exercise,regular follow-up,and various indexes were compared.Results There were significant differences between group A and group B in operation time,length of tendon incision,bone loss of tibial bone canal,diameter and length of tendon graft,and group B was better than group A.The postoperative knee Lysholm score of the two groups was significantly higher than that before operation.There was no significant difference in postoperative knee Lysholm score between the two groups.Conclusion Under arthroscopy,the anterior cruciate ligament(ACL)of the knee is reconstructed by two different fixation methods:Tightrope fixation on the femoral side and tibial side,interface compression screw fixation on the tibial side and button plate fixation on the femoral side.The effect is satisfactory after 6-24 months of follow-up.Using arthroscopic total internal fixation technology,Tightrope bilateral suspension fixation has the advantages of simpler operation,less bone loss,tendon saving,good clinical effect and wide surgical indications.It can be used in patients with osteoporosis and is worthy of clinical application.

关 键 词：关节镜 界面螺钉 可调节锁扣带袢钢板 自体月国绳肌腱 前交叉韧带 

分 类 号：R686[医药卫生—骨科学]