同种异体肌腱与自体肌腱解剖重建手术治疗慢性踝关节不稳的疗效比较  

Comparison of clinical efficacy of tendon allograft and autogenous tendon in anatomical reconstruction for chronic ankle instability

作　　者：洪凯峰 赵之颢 阿地力江·克尤木 西热扎提·阿卜杜力米提 HONG Kaifeng;ZHAO Zhihao;ADILIJIANG Keyoumu;XIREZHATI Abudulimiti(Department of Orthopaedics,Friendship Hospital,Urumqi,Xinjiang 830049,China;不详)

机构地区：[1]乌鲁木齐市友谊医院骨科,新疆830049 [2]洛浦县人民医院骨科,新疆和田848200

出　　处：《中国骨与关节损伤杂志》2025年第2期151-155,共5页Chinese Journal of Bone and Joint Injury

基　　金：新疆维吾尔自治区“青年科技人才-乡村振兴”项目(WJWY-XCZX202228)。

摘　　要：目的比较同种异体肌腱和自体肌腱解剖重建踝关节外侧副韧带手术治疗慢性踝关节不稳的临床疗效。方法纳入自2020-03—2023-03采用踝关节外侧韧带解剖重建手术治疗的30例慢性踝关节不稳,A组15例采用自体肌腱移植,B组15例采用同种异体肌腱移植。比较两组手术时间、住院时间、术后踝关节功能评分、术后距骨倾斜角、术后距骨前侧移位距离。结果30例均获得随访,随访时间26~30个月,平均27.4个月。随访期间未出现感染、移植肌腱断裂、带袢钢板移位等并发症。A组手术时间、住院时间较B组延长,差异有统计学意义(P<0.05)。所有患者术后6个月踝关节应力位X线片测量距骨前侧移位距离和距骨倾斜角较术前明显减小,而A组与B组术后6个月距骨倾斜角、距骨前侧移位距离差异无统计学意义(P>0.05)。A组与B组术后6个月、末次随访时Karlsson-Peterson评分、AOFAS评分差异无统计学意义(P>0.05)。结论踝关节外侧副韧带解剖重建手术治疗慢性踝关节不稳安全、有效,可以明显恢复患者踝关节功能,改善踝关节不稳症状;术中选择自体肌腱移植或同种异体肌腱移植对疗效无明显影响,临床医师可以根据患者情况、手术熟练程度选择合适的移植物。ObjectiveTo compare the clinical efficacy of allogeneic tendon and autologous tendon in the anatomical reconstruction of the lateral collateral ligament for the surgical treatment of chronic ankle instability.MethodsThirty cases of chronic ankle instability treated with lateral ankle ligament anatomical reconstruction from March 2020 to March 2023 were included.Fifteen patients in group A received autologous tendon grafts,while fifteen patients in group B received allogeneic tendon grafts.The surgical time,hospital stay,post-operative ankle function scores,post-operative talar tilt angle,and post-operative talar anterior translation distance were compared between the two groups.ResultsAll 30 patients were followed up for 26to 30 months,with an average follow-up of 27.4 months.No complications,including infection,graft rupture,or plate displacement occurred during the follow-up.The surgical time and hospital stay in group A were longer than those in group B,with statistically significant differences(P<0.05).At six months post-operatively,X-ray measurements of talar anterior translation distance and talar tilt angle in stress position showed significant reductions compared to preoperative values,and no statistically significant differences were found between group A and group B in talar tilt angle and anterior translation distance at six months after surgery(P>0.05).There were no statistically significant differences between the two groups in the Karlsson-Peterson score and AOFAS score at six months after operation and at the last follow-up(P>0.05).ConclusionAnatomical reconstruction of the lateral collateral ligament for chronic ankle instability is safe and effective,significantly improving ankle function and alleviating instability symptoms.The choice of autologous or allogeneic tendon graft does not significantly affect the outcome,and surgeons can select the appropriate graft based on the patient's condition and surgical expertise.

关 键 词：慢性踝关节不稳 踝关节外侧副韧带 解剖重建 同种异体肌腱 自体肌腱 

分 类 号：R686.5[医药卫生—骨科学]