LARS人工韧带结合自体腱重建ACL的早期临床疗效与二次关节镜探查情况  

Early clinical efficacy and secondary arthroscopic exploration of LARS artificial ligaments combined with autologous tendons for ACL reconstruction

作　　者：庄继川 郭氧[2] ZHUANG Jichuan;GUO Yang(Department of Orthopaedics,Xinglin Branch of the First Afiliated Hospital of Xiamen University,Xiamen,Fujian 361022,China)

机构地区：[1]厦门大学附属第一医院杏林分院骨科,福建厦门361022 [2]厦门大学附属第一医院骨运动医学与手足显微外科,福建厦门361003

出　　处：《中国骨与关节损伤杂志》2024年第8期814-819,共6页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察LARS人工韧带结合腘绳肌腱重建前交叉韧带的早期临床疗效与二次关节镜探查情况。方法回顾性分析自2017-01—2020-09于厦门大学附属第一医院骨科进行的57例前交叉韧带单束重建,根据重建时选择的移植物类型分为观察组与对照组,观察组29例采用中空LARS人工韧带联合自体腘绳肌腱杂交,对照组28例采用自体腘绳肌腱。比较两组术后3个月、6个月、12个月膝关节功能Lysholm评分、膝关节功能IKDC评分、膝关节功能Tegner评分以及重返运动情况、二次关节镜探查情况。结果所有患者均获得至少12个月的随访,末次随访时两组前抽屉试验、Lachman试验均为阴性,无关节感染、排异反应、下肢深静脉血栓形成等并发症。两组术后3个月、6个月、12个月膝关节功能Lysholm评分、膝关节功能IKDC评分、膝关节功能Tegner评分均较前术前明显提高,并持续改善,差异有统计学意义(P<0.05)。观察组术后3个月、6个月膝关节功能Lysholm评分、膝关节功能IKDC评分、膝关节功能Tegner评分均较对照组改善更明显,差异有统计学意义(P<0.05);而两组术后12个月膝关节功能Lysholm评分、膝关节功能IKDC评分、膝关节功能Tegner评分差异无统计学意义(P>0.05)。两组重返运动比例差异无统计学意义(P>0.05);但是观察组重返竞技体育比例高于对照组,差异有统计学意义(P<0.05)。两组在重返轻体育、无对抗体育、竞技体育的时机上均有明显差异(P<0.05)。两组二次关节镜探查时间为12~18个月,观察组二次关节镜探查滑膜覆盖优良率为96.6%;对照组为96.4%;两组二次关节镜探查滑膜覆盖情况差异无统计学意义(P>0.05)。结论采用LARS韧带联合自体肌腱重建前交叉韧带能够帮助患者更快恢复膝关节功能,更早重返运动,更高的竞技体育重返率,并且二次关节镜探查发现滑膜覆盖情况与常规自体腱重建前交叉韧带无明显差异Objective To observe the early clinical effect and second arthroscopic exploration of LARS artificial ligament combined with hamstring tendon for anterior cruciate ligament reconstruction.Methods A retrospective analysis was performed on 57 cases of single bundle anterior cruciate ligament reconstruction performed in the Department of Orthopedics,First Affiliated Hospital of Xiamen University from January 2017 to September 2020.The patients were divided into the observation group and the control group according to the graft types selected during reconstruction.Twenty-nine cases in the observation group underwent hollow LARS artificial ligament combined with autologous hamstring tendon.The control group of 28 patients received autologous hamstring tendon.Knee function Lysholm score,knee function IKDC score,knee function Tegner score,return to exercise and second arthroscopic exploration were compared between the two groups at 3 months,6 months and 12 months after surgery.Results All patients were followed up for at least 12 months.At the last follow-up,the anterior drawer test and Lachman test were negative in both groups,and there were no complications such as joint infection,rejection reaction,and deep venous thrombosis of lower limbs.Lysholm score of knee function,IKDC score of knee function and Tegner score of knee function at 3months,6 months and 12 months after surgery were significantly higher than those before surgery,and continued to improve,with statistical significance(P<0.05).Lysholm score of knee function,IKDC score of knee function and Tegner score of knee function in the observation group at 3 months and 6 months after surgery were significantly improved compared with the control group,with statistical significance(P<0.05).There was no significant difference in Lysholm score,IKDC score and Tegner score of knee function between the two groups 12 months after surgery(P>0.05).There was no significant difference in the proportion of return to exercise between the two groups(P>0.05).However,the proportio

关 键 词：前交叉韧带重建 LARS人工韧带 腘绳肌腱 二次关节镜探查 

分 类 号：R686.5[医药卫生—骨科学]