关节镜下自体和同种异体肌腱重建前交叉韧带的疗效比较

发布时间：2018-01-23 19:56

本文关键词： 关节镜前交叉韧带自体乆绳肌腱同种异体肌腱重建　出处：《中国矫形外科杂志》2017年06期 　论文类型：期刊论文

【摘要】：[目的]探讨关节镜下自体和同种异体肌腱重建前交叉韧带的疗效。[方法]将本院2013年1月~2014年12月收治的86例陈旧性前交叉韧带损伤重建患者随机分为2组,每组43例。自体肌腱组行自体乆绳肌腱重建,异体肌腱组行同种异体肌腱重建。术后,对两组患者重建后免疫排斥反应、膝关节功能(Lysholm、Tegner、IKDC)、胫骨前移程度(KT 2 000、Lachman)、关节运动肌力进行评价。[结果]异体肌腱组重建后免疫排斥反应[疼痛1周(32.6%)、关节积液穿刺抽液(55.8%)、白细胞计数10×10~9L~(-1)(53.5%)]大于自体肌腱组(27.9%、51.2%、46.5%),但差异无统计学意义(P0.05)。术后两组Lysholm、Tegner、IKDC评分显著升高(P0.05),但两组间差异无统计学意义(P0.05)。术后两组KT 2 000评分显著降低(P0.05),但两组间差异无统计学意义(P0.05);术后两组Lachman评价差异无统计学意义(P0.05)。异体肌腱组术后膝关节肌肉峰力矩(屈膝、伸膝、内旋、外旋)无显著变化(P0.05);自体肌腱组术后膝关节肌肉峰力矩(屈膝、内旋)显著降低(P0.05),且低于异体肌腱组(P0.05)。[结论]关节镜下自体和同种异体肌腱重建前交叉韧带的临床疗效相当,可依据患者情况合理选择。
[Abstract]:[Objective] to evaluate the effect of arthroscopic reconstruction of anterior cruciate ligament (ACL) with autologous and allogeneic tendons. [Methods: from January 2013 to December 2014, 86 patients with old anterior cruciate ligament injury and reconstruction were randomly divided into two groups, 43 cases in each group. The autologous tendon group was treated with autologous tendon reconstruction. The allogeneic tendon was reconstructed in the allogeneic tendon group. After operation, the knee joint function was Lysholm and Tegnerian IKDC. The degree of tibial anterior movement was evaluated by KT 2000 Lachmania. [Results] Immunorejection after reconstruction in allogeneic tendon group. [The pain was 32. 6% in 1 week, 55.8% in articular effusion, the white blood cell count was 10 脳 10 ~ (9) L ~ (-1) (53.5%)] and 27. 9% in autologous tendon group. There was no significant difference between the two groups (P 0.05). The Lysholm Tegnerian IKDC score in the two groups was significantly higher than that in the control group (P 0.05). However, there was no significant difference between the two groups (P 0.05). The KT 2000 score of the two groups decreased significantly after operation, but there was no significant difference between the two groups (P 0.05). There was no significant difference in Lachman evaluation between the two groups after operation (P 0.05). There was no significant change in the peak moment of knee joint muscle (flexion, extension, internal rotation, external rotation) in the allogeneic tendon group after operation (P 0.05). The peak torque (flexion, internal rotation) of knee joint in the autogenous tendon group was significantly lower than that in the allogeneic tendon group. [Conclusion: arthroscopic reconstruction of anterior cruciate ligament with autologous and allogeneic tendons is quite effective and can be reasonably selected according to the patient's condition.
【作者单位】：川北医学院附属医院骨科;
【分类号】：R687.2
【正文快照】： 前交叉韧带(anterior cruciate ligament,ACL)是膝关节的关键结构,起着稳定膝关节的功能,ACL受损后很难自行恢复,如不及时治疗,可造成患者膝关节发生继发性的损伤或关节退变,进而严重影响膝关节功能[1]。当前临床治疗ACL损伤以重建治疗为主,其中移植物的选择非常关键,是ACL重

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