自体血纤维蛋白凝块对前交叉韧带重建术后腱-骨愈合影响的临床研究
发布时间：2019-04-15 14:05
【摘要】：目的探讨自体血纤维蛋白凝块对前交叉韧带(anterior cruciate ligament,ACL)重建术后腱-骨愈合的作用及意义。方法以2014年10月—2016年1月收治并符合选择标准的34例(34膝)ACL损伤患者作为研究对象,随机分为两组(n=17);ACL重建术中试验组采用自体血纤维蛋白凝块,对照组不作该处理。两组患者术前前抽屉试验、Lachman试验及轴移试验均为阳性。两组患者性别、年龄、致伤原因、损伤侧别、受伤至手术时间以及术前膝关节活动度、Lysholm评分、美国特种外科医院(HSS)评分等一般资料比较,差异均无统计学意义(P0.05),具有可比性。记录并比较两组患者术后前抽屉试验、Lachman试验及轴移试验检查结果;术后6、24、48周,检查患膝关节活动度、Lysholm评分、HSS评分,评定膝关节功能恢复情况;行MRI检查,测量移植物信号强度、信噪比以及骨隧道扩大程度及移植物腱-骨结点T2值。结果两组患者术后均获随访48周。术后切口均Ⅰ期愈合,无1例出现关节内感染及关节粘连。术后两组患者前抽屉试验、Lachman试验及轴移试验均为阴性。术后6、24、48周,试验组Lysholm评分均明显高于对照组(P0.05);而两组膝关节活动度比较差异无统计学意义(P0.05)。术后6周,两组HSS评分比较差异无统计学意义(P0.05);24、48周时试验组HSS评分明显高于对照组(P0.05)。MRI复查显示,术后6、24、48周两组移植物信号强度、骨隧道扩大程度、移植物信噪比比较,差异均有统计学意义(P0.05)。术后6、24周两组移植物腱-骨结点T2值比较,差异有统计学意义(P0.05);48周时比较差异无统计学意义(P0.05)。结论 ACL重建术中采用自体血纤维蛋白凝块,能够有效促进移植物再血管化、加快腱-骨愈合进程。
[Abstract]:Objective to investigate the effect and significance of autologous blood fibrin clot on tendon-bone healing after anterior cruciate ligament (anterior cruciate ligament,ACL) reconstruction. Methods from October 2014 to January 2016, 34 patients (34 knees) with ACL injury were randomly divided into two groups (n = 17). Autologous blood fibrin clot was used in the experimental group during ACL reconstruction, but not in the control group. The anterior drawer test, Lachman test and axisymmetric test were all positive in both groups. Sex, age, cause of injury, side injury, time from injury to operation, preoperative knee motion, Lysholm score and (HSS) score of American special surgical hospital were compared between the two groups. The differences were not statistically significant (P0.05), and were comparable. The results of anterior drawer test, Lachman test and axial shift test were recorded and compared between the two groups, and the knee joint activity, Lysholm score and HSS score were evaluated at 6, 24, 48 weeks after operation. The graft signal intensity, signal-to-noise ratio (SNR), bone tunnel enlargement and T _ 2 value of tendon-bone node were measured by MRI. Results the patients in both groups were followed up for 48 weeks. There was no intra-articular infection and joint adhesion in all cases. The anterior drawer test, Lachman test and axial shift test were negative in the two groups after operation. 6, 24, 48 weeks after operation, the Lysholm scores in the experimental group were significantly higher than those in the control group (P0.05), but there was no significant difference in the knee motion between the two groups (P0.05). 6 weeks after operation, there was no significant difference in HSS scores between the two groups (P0.05). The HSS score of the experimental group was significantly higher than that of the control group at 24 and 48 weeks after operation (P0.05). 6, 24 and 48 weeks after operation, the signal intensity of graft, the extent of bone tunnel enlargement, and the signal-to-noise ratio of the graft were significantly different between the two groups (P0.05). There was significant difference in T _ 2 value of tendon-bone node between the two groups at 6 and 24 weeks after operation (P0.05), but there was no significant difference at 48 weeks (P0.05). Conclusion autogenous blood fibrin clot can effectively promote graft revascularization and accelerate tendon-bone healing in ACL reconstruction.
【作者单位】： 漯河医学高等专科学校第二附属医院骨关节科;河南省人民医院骨关节科;
【基金】：河南省基础与前沿技术研究计划项目(162300410093) 河南省医学科技攻关项目(201602196)~~
【分类号】：R687.4
本文编号：2458211
[Abstract]:Objective to investigate the effect and significance of autologous blood fibrin clot on tendon-bone healing after anterior cruciate ligament (anterior cruciate ligament,ACL) reconstruction. Methods from October 2014 to January 2016, 34 patients (34 knees) with ACL injury were randomly divided into two groups (n = 17). Autologous blood fibrin clot was used in the experimental group during ACL reconstruction, but not in the control group. The anterior drawer test, Lachman test and axisymmetric test were all positive in both groups. Sex, age, cause of injury, side injury, time from injury to operation, preoperative knee motion, Lysholm score and (HSS) score of American special surgical hospital were compared between the two groups. The differences were not statistically significant (P0.05), and were comparable. The results of anterior drawer test, Lachman test and axial shift test were recorded and compared between the two groups, and the knee joint activity, Lysholm score and HSS score were evaluated at 6, 24, 48 weeks after operation. The graft signal intensity, signal-to-noise ratio (SNR), bone tunnel enlargement and T _ 2 value of tendon-bone node were measured by MRI. Results the patients in both groups were followed up for 48 weeks. There was no intra-articular infection and joint adhesion in all cases. The anterior drawer test, Lachman test and axial shift test were negative in the two groups after operation. 6, 24, 48 weeks after operation, the Lysholm scores in the experimental group were significantly higher than those in the control group (P0.05), but there was no significant difference in the knee motion between the two groups (P0.05). 6 weeks after operation, there was no significant difference in HSS scores between the two groups (P0.05). The HSS score of the experimental group was significantly higher than that of the control group at 24 and 48 weeks after operation (P0.05). 6, 24 and 48 weeks after operation, the signal intensity of graft, the extent of bone tunnel enlargement, and the signal-to-noise ratio of the graft were significantly different between the two groups (P0.05). There was significant difference in T _ 2 value of tendon-bone node between the two groups at 6 and 24 weeks after operation (P0.05), but there was no significant difference at 48 weeks (P0.05). Conclusion autogenous blood fibrin clot can effectively promote graft revascularization and accelerate tendon-bone healing in ACL reconstruction.
【作者单位】： 漯河医学高等专科学校第二附属医院骨关节科;河南省人民医院骨关节科;
【基金】：河南省基础与前沿技术研究计划项目(162300410093) 河南省医学科技攻关项目(201602196)~~
【分类号】：R687.4
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