摘要
背景:关节镜下采用腘绳肌腱及生物界面螺钉重建交叉韧带的临床实验已经在国内广泛开展,但是对于腘绳肌腱细小的南方人应用此种修复方式的临床研究较少。目的:首次分析关节镜下腘绳肌腱及界面螺钉重建海南地区人群交叉韧带的效果。方法:回顾性分析海南地区27例交叉韧带重建的病例临床资料,其中24例前交叉韧带断裂,2例后交叉韧带断裂,1例前、后交叉韧带同时断裂。采用腘绳肌腱及生物界面螺钉进行重建,其中自体腘绳肌23例,同种异体腘绳肌4例。术后定期复查膝关节功能并指导功能锻炼,应用Lysholm评分和国际膝关节评分委员会(IKDC)韧带评分系统进行功能评定。结果与结论:22例患者获随访8.7(3～24)个月,1例隐神经损伤,1例移植后3个月膝关节化脓性感染,行移植物取出待二期行翻修;除感染1例外,所有患膝移植后活动均正常,不稳感消失,同种异体腱组患膝皮温较高,但体温不超过38℃;术后Lysholm评分较术前明显增加(P<0.01),其中19例术后IKDC评分正常或接近正常,说明自体或同种异体腘绳肌腱是修复前交叉韧带或后交叉韧带的良好移植物,腘绳肌腱及界面螺钉重建交叉韧带效果满意。
BACKGROUND：Clinical experiments of cruciate ligament reconstruction with hamstring tendon autograft or allograft fixed by bioabsorhable interference screw under arthroscope have been extensively conducted. However,clinical studies are few for the southerners with thin hamstring tendon. OBJECTIVE：To introduce the clinical effect of cruciate ligament reconstruction with hamstring tendon autograft or allograft fixed by bioabsorhable interference screw under arthroscope. METHODS：A retrospective analysis was conducted on 27 cases of cruciate ligament injury,including 24 cases of anterior cruciate ligament （ACL） injury,2 of posterior cruciate ligament （PCL） injury,and 1 of both ACL and PCL injury,reconstruction with hamstring tendon autograft 23 cases and allograft 4 cases. Periodical examination was done on rehabilitation exercise and knee joint function. Knee joint function was determined by IKDC,Lysholm knee functional scales and Lysholm scores. RESULTS AND CONCLUSION：The 22 cases were followed up for 3-24 months （average 8.7 months）. One had saphenous nerve injury; intraarticular infection happened in 1 cases 3 months after operation,and the graft was removed,waiting for the revision reconstruction. All cases except the infected one got normal function of knee joint after operation and knee joint stability was recovered. The temperature of the affected knee was higher in allograft group in several weeks postoperation,but the body temperature was scarcely higher than 38 degree. A total of 19 patients got normal IKDC score,and the average postoperative Lysholm knee functional scales were significantly increased （P 0.01）. Results show that hamstring tendon autograft or allograft is ideal graft for ACL or PCL. Good result was expected for ACL or PCL reconstruction with hamstring tendon autograft fixed by bioresorbable interference screws.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第52期9831-9834,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
