中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2012年
9期
809-812
,共4页
白正武%张明%贺业腾%闫新峰
白正武%張明%賀業騰%閆新峰
백정무%장명%하업등%염신봉
前交叉韧带%关节镜检查%移植%膝关节
前交扠韌帶%關節鏡檢查%移植%膝關節
전교차인대%관절경검사%이식%슬관절
Anterior cruciate ligament%Arthroscopy%Transplantation%Knee joint
目的 探讨自体胭绳肌腱、同种异体肌腱对重建前交叉韧带(anterior cruciate ligament,ACL)术后骨隧道的变化和疗效差异. 方法 选择2008年6月- 2009年11月收治的行关节镜下ACL重建术61例ACL损伤患者.根据移植物不同分为两组:同种异体肌腱重建组(A组,27例)和自体胭绳肌腱重建组(B组,34例).术后1周、6～12个月进行MRI检查,测量矢状位骨隧道开口、开口1 cm、骨隧道最宽处三点骨隧道直径,以术后1周对应部位骨隧道直径为衡量标准,对其差值进行统计学分析.采用Lysholm评分评估各组临床疗效. 结果 术后随访:A组平均8.4个月,B组平均8.5个月.两组患者资料术前比较差异无统计学意义.术后MRI随访发现股骨侧、胫骨侧骨隧道直径均有不同程度的增宽,其中胫骨侧较股骨侧增宽明显,两组在股骨、胫骨三个不同测量部位骨隧道增宽差异无统计学意义.所有患者关节稳定性良好.术后Lysholm评分两组比较差异无统计学意义(P＞0.05). 结论 移植物不同是影响ACL重建术后骨隧道扩大的因素之一.自体肌腱、同种异体肌腱对ACL重建术后骨隧道扩大差异无统计学意义,与术后临床疗效无相关性.
目的 探討自體胭繩肌腱、同種異體肌腱對重建前交扠韌帶(anterior cruciate ligament,ACL)術後骨隧道的變化和療效差異. 方法 選擇2008年6月- 2009年11月收治的行關節鏡下ACL重建術61例ACL損傷患者.根據移植物不同分為兩組:同種異體肌腱重建組(A組,27例)和自體胭繩肌腱重建組(B組,34例).術後1週、6～12箇月進行MRI檢查,測量矢狀位骨隧道開口、開口1 cm、骨隧道最寬處三點骨隧道直徑,以術後1週對應部位骨隧道直徑為衡量標準,對其差值進行統計學分析.採用Lysholm評分評估各組臨床療效. 結果 術後隨訪:A組平均8.4箇月,B組平均8.5箇月.兩組患者資料術前比較差異無統計學意義.術後MRI隨訪髮現股骨側、脛骨側骨隧道直徑均有不同程度的增寬,其中脛骨側較股骨側增寬明顯,兩組在股骨、脛骨三箇不同測量部位骨隧道增寬差異無統計學意義.所有患者關節穩定性良好.術後Lysholm評分兩組比較差異無統計學意義(P＞0.05). 結論 移植物不同是影響ACL重建術後骨隧道擴大的因素之一.自體肌腱、同種異體肌腱對ACL重建術後骨隧道擴大差異無統計學意義,與術後臨床療效無相關性.
목적 탐토자체연승기건、동충이체기건대중건전교차인대(anterior cruciate ligament,ACL)술후골수도적변화화료효차이. 방법 선택2008년6월- 2009년11월수치적행관절경하ACL중건술61례ACL손상환자.근거이식물불동분위량조:동충이체기건중건조(A조,27례)화자체연승기건중건조(B조,34례).술후1주、6～12개월진행MRI검사,측량시상위골수도개구、개구1 cm、골수도최관처삼점골수도직경,이술후1주대응부위골수도직경위형량표준,대기차치진행통계학분석.채용Lysholm평분평고각조림상료효. 결과 술후수방:A조평균8.4개월,B조평균8.5개월.량조환자자료술전비교차이무통계학의의.술후MRI수방발현고골측、경골측골수도직경균유불동정도적증관,기중경골측교고골측증관명현,량조재고골、경골삼개불동측량부위골수도증관차이무통계학의의.소유환자관절은정성량호.술후Lysholm평분량조비교차이무통계학의의(P＞0.05). 결론 이식물불동시영향ACL중건술후골수도확대적인소지일.자체기건、동충이체기건대ACL중건술후골수도확대차이무통계학의의,여술후림상료효무상관성.
Objective To investigate the changes of bone tunnel and differences of clinical outcomes after anterior cruciate ligament (ACL) reconstruction with hamstring tendons from autografts and allografts. Methods The study involved in 61 patients with ACL injury undergone arthroscopic ACL reconstruction from June 2008 to November 2009.According to ACL graft differences,61 patients were assigned to two groups,ie,Group A ( reconstruction with tendon allografts,n =27 ) and Group B ( reconstruction with tendon autografts,n =34).MRI examination was performed one week and 6-12 months post-operatively to measure the sagittal bone tunnel diameters at the aperture location,at the location of 1cm away from the aperture and at the widest location of tunnel.Taking the bone tunnel diameter at each location one week post-operatively as the measurement criteria,the differences of bone tunnel diameters at each corresponding location were analyzed statistically.Lysholm score was used to evaluate the clinical effects in the two groups. Results Group A and B were followed up for average 8.4 months and 8.5 months,respectively.Pre-operative clinical data of the two groups had no significant difference.MRI follow-up showed that the tunnel diameters at femoral side and tibial side both had different degree of enlargement.Meanwhile,the enlargement degree at the tibial side was larger than that at the femoral side,with no statistical differences of the two groups regarding tunnel enlargement of the three measurement locations at femoral and tibial sides.Joint stability in all patients was good.The two groups showed no significant difference in Lysholm score after operation ( P ＞ 0.05 ). Conclusions Graft difference is a factor for bone tunnel enlargement after ACL surgery.Autologous and allogenic tendons show no difference in their role in bone tunnel enlargement after ACL surgery or correlation with clinical effects.
