关节镜下自体腓骨长肌腱与同种异体肌腱重建前交叉韧带的疗效分析

发布时间：2018-05-03 08:25

本文选题：自体腓骨长肌腱 + 同种异体肌腱　；参考：《广东医学》2017年24期

【摘要】：目的研究分析自体腓骨长肌腱与同种异体肌腱在重建前交叉韧带中的临床疗效。方法确诊为前交叉韧带损伤并行手术治疗的患者,共计58例,根据术中移植物来源,将其分为A组(自体腓骨长肌腱重建组,n=29)和B组(同种异体肌腱重建组,n=29)。所有患者均统计手术时间、术中出血量、关节肿胀、足弓情况及踝外翻;评估手术前后膝关节Lysholm、Tegner、IKDC、VAS评分、KT-1000测量值及踝关节Kofoed评分。结果所有患者均获得平均(12.69±0.90)个月(11~14个月)随访,无神经血管损伤、感染、断裂、足弓塌陷与外翻受限等并发症。术前,A组与B组间的Lysholm、Tegner、IKDC、VAS、Kofoed评分及KT-1000测量值差异无统计学意义(P0.05)。A组、B组的手术时间为(103.62±9.15)min、(87.76±8.08)min,术中出血量为(71.03±15.49)mL、(55.86±11.03)mL,出院时膝关节肿胀发生率为3.4%、17.2%,两者之间差异有统计学意义(P0.05)。术后,两组末次随访的评分较治疗前均有明显改善,并差异有统计学意义(P0.05);A组与B组间的Lysholm、Tegner、IKDC、VAS、Kofoed评分及KT-1000测量值差异无统计学意义(P0.05);A组的Kofoed评分与术前相比无明显差异(P0.05)。结论关节镜下自体腓骨长肌腱与同种异体肌腱在重建前交叉韧带的疗效相似。腓骨长肌腱重建一定程度上增加了手术时间及出血量,但具有并发症及费用少等优点,可优先考虑使用。
[Abstract]:Objective to study the clinical effect of reconstruction of anterior cruciate ligament (ACL) with autogenous long fibula tendon and allogeneic tendon. Methods 58 patients with anterior cruciate ligament injury underwent surgical treatment were divided into two groups: group A (group A) and group B (group B). The time of operation, intraoperative bleeding volume, joint swelling, arches of foot and ankle valgus were calculated in all patients, and the KT-1000 and Kofoed scores of knee joint were evaluated before and after operation. Results all the patients were followed up for an average of 12.69 卤0.90 months (11-14 months). There were no complications such as nerve and blood vessel injury, infection, rupture, arch collapse and valgus limitation. There was no significant difference in the Kofoed score and KT-1000 measurement between group A and group B (P 0.05). The operative time of group B was 103.62 卤9.15 min, the amount of intraoperative bleeding was 71.03 卤15.49mL / L, and the incidence of knee swelling was 3.40.17.2mm / L, respectively. There was significant difference between the two groups in the incidence of knee swelling at discharge (P 0.05). After operation, the scores of the last follow-up in the two groups were significantly improved compared with those before treatment, and the difference was statistically significant (P 0.05). There was no significant difference in the Kofoed scores and the KT-1000 measurement values between group A and group B. There was no significant difference in Kofoed score between group A and group B (P 0.05), and there was no significant difference in Kofoed score between group A and group B (P 0.05). Conclusion the effect of arthroscopic reconstruction of anterior cruciate ligament with autologous long fibula tendon and allogeneic tendon is similar. The reconstruction of the long tendon of fibula increases the operation time and blood loss to some extent, but it has the advantages of less complications and less cost, so it can be used preferentially.
【作者单位】：湖南师范大学附属第一医院湖南省人民医院关节与运动医学科;
【基金】：湖南省科技厅重点研发计划-社发支撑领域项目(编号:2015SK2047-1) 重庆市博士后科研项目特别资助项目(编号:Xm2016052) 湖南师范大学临床医学院仁术科研发展基金资助项目(编号:2015-15)
【分类号】：R687.2

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