目的：探讨4束自体腘绳肌腱与异体胫前肌腱移植重建前交叉韧带（ACL）的临床疗效。方法回顾性分析2010年9月至2013年6月在广州市番禺中心医院行关节镜下ACL重建术的42例单纯ACL断裂患者的临床资料，根据移植物的不同分为自体组（4束自体腘绳肌腱移植，22例）和异体组（异体胫前肌腱移植，20例），比较两组手术时间、发热时间和伤口愈合时间的差异；采用Lysholm膝关节评分、国际膝关节文献委员会（IKDC）膝关节功能主观评分表评估膝关节功能，KT-2000关节测量仪评估膝关节稳定性。结果自体组手术时间长于异体组，发热时间少于异体组，两组比较，差异有统计学意义（P＜0.05）。自体组和异体组随访时间分别为（27±3）和（27±4）个月。随访期间两组均无移植物断裂松动、下肢深静脉栓塞、伤口不愈合等并发症发生。末次随访时，两组Lysholm评分、IKDC分级、KT2000平移距离均较术前明显改善（P＜0.05），但两组之间上述指标比较，差异无统计学意义（P＞0.05）。结论4束自体腘绳肌腱与异体胫前肌腱重建ACL的临床疗效无明显差异；在缺乏自体韧带情况下，异体胫前肌腱是良好的替代物之一。%Objective To investigate the clinical effects of arthroscopic reconstruction of anterior cruciate ligament (ACL) using either 4 bundles hamstring tendon autograft or anterior tibial tendon allograft. Methods From September 2010 to June 2013, clinical data of 42 patients with ACL rupture underwent arthroscopic reconstruction in Guangzhou Panyu Central Hospital, were analyzed retrospectively. According to different kinds of grafts, the patients were divided into autograft group (n = 22, using 4 bundles hamstring tendon autograft) and allograft group (n = 20, using anterior tibial tendon allograft). Differences of operative time, fever time and wound healing time were compared between two groups; Lysholm knee joint scores, International Knee Documentation Committee (IKDC) scores were recorded to evaluate knee joint function, and the stability of knee joint was examined by KT-2000 arthrometer. Results Compared with allograft group, operative time was longer, and fever time was shorter in autograft group, the differences had statistical significance (P <0.05). The average follow-up was (27 ± 3) months in autograft group and (27 ± 4) months in allograft group. During the follow-up, there were no complications of graft breakage, loosening, deep vein thrombosis of the lower extremity, and non-healing wounds. At the last follow-up, Lysholm scores, IKDC grading and KT-2000 forward distance were all improved compared with preoperative ones (P<0.05), while there were no statistical differences between two groups (P >0.05). Conclusion Using 4 bundles hamstring tendon autograft and anterior tendon allograft will make no significant difference in clinical outcome, as a result, the latter could be a good substitute for patients whose tendon autograft is not sufficient for arthroscopic reconstruction of ACL.
展开▼
