关节镜下自体半腱肌双悬吊固定与传统固定前交叉韧带重建术的比较研究  

Comparative study of arthroscopic autologous semitendinosus double suspension fixation versus traditional fixation in anterior cruciate ligament reconstruction

作　　者：王良铭[1] 张小路[1] WANG Liangming;ZHANG Xiaolu(Department of Orthopaedics,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,Fujian,China)

机构地区：[1]福建医科大学附属第二医院骨科,福建泉州362000

出　　处：《中华骨与关节外科杂志》2025年第4期298-305,共8页Chinese Journal of Bone and Joint Surgery

基　　金：福建医科大学启航基金(2020QH1114)。

摘　　要：目的:探讨关节镜下自体半腱肌双悬吊固定与传统固定前交叉韧带(ACL)重建术对患者膝关节功能及稳定性的影响。方法:回顾性分析2018年1月至2023年12月福建医科大学附属第二医院行ACL重建的96例患者的临床资料,根据手术方式分为双悬吊组49例(采用自体半腱肌双悬吊固定)与传统组47例(采用股骨端悬吊固定、胫骨端挤压螺钉固定)。比较两组患者的手术时间、移植物直径和长度;比较术后1、3、5 d时疼痛视觉模拟评分(VAS);比较术前及术后3、6、12个月的膝关节功能及稳定性,膝关节功能评价采用国际膝关节评分委员会(IKDC)评分和Lysholm膝关节评分,膝关节稳定性评价采用双侧膝关节胫骨前移差值;比较两组患者术前及术后12个月的患侧膝关节周径,以评价肢体肿胀情况。结果:双悬吊组患者移植物直径小于传统组、移植物长度短于传统组(P均<0.05)。两组患者术后5 d疼痛VAS评分均低于术后3 d和术后1 d,且术后3 d低于术后1 d(P均<0.05);双悬吊组患者术后1、3、5 d疼痛VAS评分均低于传统组(P均<0.05)。两组患者术后3、6、12个月IKDC评分和Lysholm评分均高于术前,且术后6个月高于术后3个月、术后12个月高于术后6个月(P均<0.05);两组患者术前、术后3个月、术后6个月IKDC评分、Lysholm评分比较,差异均无统计学意义(P均>0.05),双悬吊组术后12个月IKDC评分、Lysholm评分均高于传统组(P均<0.05)。两组患者术后3、6、12个月双侧膝关节胫骨前移差值均小于术前,且术后6个月小于术后3个月、术后12个月小于术后6个月(P均<0.05);两组患者术前及术后3、6、12个月双侧膝关节胫骨前移差值比较,差异均无统计学意义(P均>0.05)。两组患者术前患侧膝关节周径比较,差异无统计学意义(P>0.05);两组患者术后12个月患侧膝关节周径均较术前减小(P均<0.05),但两组比较差异无统计学意义(P>0.05)。结论:采用关节镜下�Objective:To compare the effects of anterior cruciate ligament(ACL)reconstruction using arthroscopic autologous semitendinosus double suspension fixation versus traditional fixation on knee joint function and stability.Methods:A retrospective analysis was conducted on the clinical data of 96 patients who underwent ACL reconstruction at the Second Affiliated Hospital of Fujian Medical University from January 2018 to December 2023.Based on the surgical technique,patients were divided into the double suspension fixation group(n=49,autologous semitendinosus double suspension fixation)and the traditional fixation group(n=47,femoral suspension fixation,and tibial interference screw fixation).Surgical duration,graft diameter,and graft length were compared between the two groups.Postoperative pain was assessed using the visual analog scale(VAS)at 1,3,and 5 days postoperatively.Knee function and stability were evaluated preoperatively and at 3,6,and 12 months postoperatively.Knee function was assessed using the International Knee Documentation Committee(IKDC)score and the Lysholm knee scores.The knee stability was evaluated based on the anterior tibial translation difference between the bilateral knees.Additionally,limb swelling was assessed by comparing the circumference of the affected knee preoperatively and at 12 months postoperatively.Results:The graft diameter and length in the double suspension fixation group were significantly smaller than those in the traditional fixation group(both P<0.05).In both groups,VAS scores at postoperative day 5 were lower than those at postoperative days 3 and 1,and VAS scores at postoperative day 3 were lower than those at day 1(all P<0.05).The VAS scores of the double suspension fixation group were significantly lower at postoperative days 1,3,and 5 compared to the traditional fixation group(all P<0.05).At 3,6,and 12 months postoperatively,IKDC and Lysholm scores were significantly higher than preoperative values in both groups,with scores at 6 months exceeding those at 3 months and

关 键 词：前交叉韧带重建 关节镜 自体半腱肌 双悬吊固定 膝关节功能 关节稳定性 

分 类 号：R686.5[医药卫生—骨科学]