关节镜下自体腓骨长肌腱与同种异体肌腱重建膝关节前交叉韧带的对比研究

摘要

目的：比较关节镜下自体腓骨长肌腱及同种异体肌腱移植重建膝关节前交叉韧带的临床疗效。方法选取2008年6月—2013年6月前交叉韧带损伤患者60例，数字表法随机分为自体腓骨长肌腱组（31例）和异体肌腱组（29例），比较2组基本资料、手术情况、中立位前抽屉试验（ADT）和国际膝关节评分（IKDC）、Lysholm及Tegner评分。结果2组患者的性别、年龄、损伤部位以及治疗前的ADT试验阳性率、Lachman试验阳性率、浮髌试验阳性率、Lysholm评分、Tegner评分等差异无统计学意义（ P ＞0 y．05）。异体肌腱组手术时间为（91．3±12．5）min，短于自体腓骨长肌腱组的（66．1±13．5）min（ t ＝5．225， P ＝0．000）；与术前比较，2组术后IKDC评分、Lysholm评分、Tegner评分、胫骨前移距离等指标均改善（ P ＜0．01），但2组术后比较差异无统计学意义（ P ＞0．05）；术后1年，2组患者的IKDC评分等级、Lysholm评分等级及ADT试验结果差异均无统计学意义（ P ＞0．05）。结论关节镜下同种异体肌腱重建膝关节前交叉韧带近期疗效较为满意，与关节镜下自体腓骨长肌腱重建膝关节前后交叉韧带相似。%Objective To compare the clinical effects of arthroscopic reconstruction of anterior cruciate ligament with long tendon autograft and allograft tendon allograft.Methods Sixty cases of patients with cruciate ligament injury were select-ed from June 2008 to June 2013.The digital table method used to randomly divided patients into autogenous fibula long tendon group (31 cases), allogeneic tendon group (29 cases), and compared with the basic data, surgical cases of neutral position in the front drawer test ( ADT) and international knee score ( IKDC) , Lysholm and Tegner score.Results Differences in gender, age, site of injury and treatment of ADT test positive rate, Lachman test positive rate, floating patella test positive rate, Lysholm score and the Tegner score of two groups of patients showed no statistical significance ( P >0.05).Allogeneic tendon group, operation time were (91.3 ±12.5) min, short than autogenous fibula long tendon group (66.1 ±13.5) min (t =5.225, P =0.000).Compared with those before operation and after operation in both of the 2 groups, IKDC score, Ly-sholm score and the Tegner score, tibia forward distance index were improved ( P <0.01), but after operation no significant differences between the 2 groups were found ( P >0.05);1 year after operation, patients in the two groups'IKDC rating, Ly-sholm rating and ADT experiment's differences had no statistical significance ( P >0.05).Conclusion Arthroscopic recon-struction of anterior cruciate ligaments of knee joint showed satisfactied effect, and anterior cruciate ligament reconstruction was similar with the arthroscopic reconstruction of the knee joint.