膝前交叉韧带重建10年后自体和同种异体移植物成熟度及术后临床效果分析  

Analysis of autograft and allograft maturity and postoperative clinical outcomes 10 years after anterior cruciate ligament reconstruction

作　　者：崔勇 杨靖琦 王建朝[1] 邵德成[1] 陈百成[1] 张晓阳[1] Cui Yong;Yang Jingqi;Wang Jianzhao;Shao Decheng;Chen Baicheng;Zhang Xiaoyang(Sports Medicine Department,Hebei Medical University Third Hospital,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第三医院运动医学科,河北石家庄050011

出　　处：《中国运动医学杂志》2024年第3期175-180,共6页Chinese Journal of Sports Medicine

摘　　要：目的:评估并比较膝前交叉韧带重建10年后自体和异体移植物成熟度及术后临床效果。方法:对64名前交叉韧带重建的患者进行平均约10年的回顾性分析。其中自体移植物36例(56.2%),同种异体移植物28例(43.8%),记录两组患者的膝关节Lysholm评分、IKDC主观评分和稳定性试验结果(KT-1000侧-侧差值、Lachman试验),并通过膝关节磁共振成像(MRI)扫描,记录两种移植物的成熟度[信噪比(SNQ)]、对两组患者的上述指标进行对比分析。结果:术后平均随访时间自体移植物组为10.1±2.1年,同种异体移植物组为10.5±1.8年,两组间差异无统计学意义(P=0.376);SNQ值自体移植物组为24.1±8.8,同种异体移植物组为23.2±8.7,两组间差异无统计学意义(P=0.652);Lysholm评分自体移植物组为90±10.3分,同种异体移植物组为89.4±8.9分,两组间差异无统计学意义(P=0.805);IKDC评分自体移植物组(84.5±8.3分)高于同种异体移植物组(80.4±7.8分),但两组间差异无统计学意义(P=0.075);KT1000测量韧带紧张度异常的发生率,同种异体移植物组(14.3%)高于自体移植物组(8.3%),但差异无统计学意义(P=0.724);两组患者术后随访时的关节前向稳定性差异无统计学意义(P=0.923);自体移植物组中2例发生ACL再撕裂(5.6%),同种异体移植物组为2例(7.1%),两组间差异无统计学意义(P=0.795)。结论:在ACLR术后平均10年的患者中,使用自体或同种异体移植物的两组患者的移植物成熟度差异无统计学意义,两组间的临床效果、关节稳定性差异无统计学意义,移植物再撕裂率相当。Objective To evaluate and compare the maturity of autografts and allografts as well as the postoperative clinical outcomes 10 years after anterior cruciate ligament reconstruction(ACLR).Methods A retrospective analysis was conducted on 64 patients who underwent anterior cruciate ligament reconstruction,with an average follow-up period of about 10 years.Autografts were used in 36cases(56.2%),and allografts in 28 cases(43.8%).Both groups were recorded the knee Lysholm scores,IKDC subjective scores,and stability tests results(KT-1000 side-to-side difference and Lachman test).Moreover,graft maturity was assessed using the knee magnetic resonance imaging(MRI),and the Signal-to-Noise Quotient(SNQ) for both types of grafts was measured.Results No significant differences were observed between the autograft and allograft groups in the average follow-up time(10.1 ± 2.1 and 10.5 ± 1.8 years)(P=0.376),the SNQ value(24.1 ± 8.8 and 23.2 ± 8.7)(P=0.652),the Lysholm score(90 ± 10.3 and 89.4 ± 8.9)(P=0.805) and the anterior joint stability during follow-up(P=0.923).Moreover,the average IKDC score and incidence of abnormal tension of the ligament measured by KT1000 of the autograft group were higher than the allograft group[(84.5 ± 8.3)vs.(80.4 ± 7.8),P=0.075;14.3% vs.8.3%,P=0.724].Meanwhile,ACL re-tear occurred to two cases in the autograft group(5.6%) and the allograft group(7.1%),respectively,showing no significant difference(P=0.795).Conclusion Ten years after ACLR,no significant differences are found in graft maturity,clinical outcomes,or joint stability between patients using autografts and allografts.Moreover,the rate of graft re-tear is comparable between the two groups.

关 键 词：前交叉韧带 信噪比 腘绳肌腱 同种异体肌腱 临床效果 

分 类 号：R68[医药卫生—骨科学]