关节镜下应用自体或异体肌腱同期重建前后交叉韧带的疗效  

Arthroscopic reconstruction of anterior and posterior cruciate ligament tendons usingg autologous or allogeneic tendons

作　　者：江仁奇 宋涛 张文韬 从飞 王璟赫 Jiang Renqi;Song Tao;Zhang Wentao(Microsurgical Repair Department of Orthopaedics,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安市红会医院骨显微修复外科,710054

出　　处：《美中国际创伤杂志》2024年第1期11-13,54,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨关节镜下应用自体或异体肌腱同期重建前交叉韧带(anteriou cruciate ligament,ACL)和后交叉韧带(posterior cruciate ligament,PCL)的临床疗效。方法:2019年5月至2022年7月,28例ACL、PCL损伤患者在关节镜下应用自体或异体肌腱同期重建膝关节ACL、PCL,合并膝内、外侧半月板损伤患者在重建的同时进行修整,术后佩戴可调式膝关节固定带3个月行康复训练。根据国际膝关节文献委员(international knee documentation committee,IKDC)评分和Lysholm膝关节功能评分表对患膝功能进行评估。结果:28例随访18-30个月,平均24个月。患者在0和20°应力测试时稳定性均完全恢复,IKDC评分入院时均为显著异常(D级),术后随访时正常(A级)18例(64.3%,18/28),接近正常(B级)8例(28.6%,18/28),异常(C级)2例(7.1%,2/28)。Lysholm评分由术前平均(46.7±4.2)分提高到(89.6±2.8)分,差异有统计学意义(t=8.563,P<0.01)。所有患者膝关节功能明显改善。结论:关节镜下同期重建ACL、PCL具有损伤小,能早期功能锻炼,关节粘连率低,能有效恢复关节功能,治疗效果满意。Objective:To investigate the clinical effect of arthroscopic reconstruction of anterior cruciate ligament(ACL)and posterior cruciate ligament(PCL)with autologous or allogeneic tendon.Methods:From May 2019 to July 2022,28 patients with ACL and PCL injuries underwent arthroscopic reconstruction of ACL and PCL using autologous or allogeneic tendons.Patients with medial and lateral meniscus injuries were repaired during Reconstruction.After operation,they were trained by wearing adjustable knee joint fixation belt for 3 months.The function of the affected knee was evaluated according to the IKDC score and the Lysholm knee function score.Results:28 cases were followed up for 18-30 months(mean 24 months).Stability was completely restored at O and 20°stress tests.IKDC scores were significantly abnormal(grade D)at admission,18(64.3%,18/28)were normal(grade A),8(28.6%,18/28)were close to normal(grade B),and 2 cases(7.1%,2/28)were abnormal(grade C)at postoperative follow-up.Lysholm score increased from(46.7±4.2)to(89.6±2.8),the dfference was statistically significant(t=8.563,P<0.01).Knee function was improved in all patients.Conclusion:Arthroscopic simultaneous reconstruction of ACL and PCL has the advantages of less damage,early functional exercise,low rate of joint adhesion,and effective recovery of joint function.

关 键 词：关节镜 自体或异体肌腱 前、后交叉韧带 同期重建 

分 类 号：R68[医药卫生—骨科学]