膝关节镜下自体腘绳肌腱和同种异体肌腱移植重建前交叉韧带对比观察.pdfVIP

中国骨伤2008年4月第2t卷第4期 China J OrthopTrauma，Apr。2008．Vol。2t，No。4 · 267· · 临床 研究 · 膝关节镜下自体胭绳肌腱和同种异体肌腱移植 重建前交叉韧带对比观察 刘红光，陈述祥，赵崇达，丁林坚，司徒坚 (暨南大学医学院第六附属医院 江门市五邑中医院，广东 江门 529031) 【摘要】 目的：探讨关节镜下同种异体肌腱和自体胭绳肌腱重建前交叉韧带的疗效。方法：收集32例前交叉韧 带损伤病例，单纯前交叉韧带(ACL)损伤29例，与后交叉韧带(PCL)同时损伤3例。分为2组，同种异体肌腱重建l5例， 男l2例，女3例，年龄23-6l岁；自体胭绳肌腱重建 l7例，男l1例，女6例，年龄 17-57岁。用可吸收或钛挤压螺钉 固定，观察并记录治疗后的症状、体征变化和Lysholm评分以及术后6个月的功能康复情况。结果：全部病例均获得随 访，时间6-8个月，所有病例无膝前区疼痛，临床症状消失，膝关节功能得到改善。同种异体肌腱重建前交叉韧带5例 患者仍出现Lachman征阳性体征，其中l例产生严重的排斥反应，关节镜复查韧带完全吸收。2组患者治疗后Lvsholm 评分分别为平均(88．5+7．2)分和(93．2+8．5)分，差异无统计学意义(P0．05)。结论：关节镜下两种方法重建前交叉韧带 都有较好的疗效，同种异体肌腱重建交叉韧带早期有更多的症状，有明显的个体差异，重建交叉韧带尽可能选用自体 胭绳肌腱。 【关键词】关节镜； 前交叉韧带； 修复外科手术； 临床对照试验 Comparative study oil reconstruction of anterior cruciate Hgaments with allografts and hamstring tendon uiider arthroscopy LIUHong-guang，CHENShu-xiang，ZHA0Chong-da，DINGLin-jian，SITUJian．Department ofOrthopaedics， Wuyi TCMHospital ofJiangmen(the Sixth AffiliatedHospital ofMedicine C 啦 of五 n Univers )，Jianamen 529031， Guangdong，China ABSTRACT Objective．-To evaluate the effect of reconstruction of anterior cruciate ligaments(ACL)with allogeneic tendon or autologous hamstring tendon under arthroscopy．Methods：Thirty—two cases of ACL injury(3 cases compound with PCL inju— ry)were reviewed．All the patients were divided into two groups randomly．Fifteen cases were reconstructed with hamstring tendon，including12male and 3femalewiththe age rangingfrom23to61 years，Seventeen caseswere reconstructedwithallo— scaft，including 1 1 male and 6 female with the age ranging from 17 to 57 years．The tendons were fixed with absorbable or Ti SCreWS．All patients were recorded symptoms，physical signs and Lysholm Scores two weeks after operation，and functional re— habilitation of knee six months after operation，Result