摘要
背景:自体腘绳肌腱重建前交叉韧带是目前治疗前交叉韧带损伤的主流方法,而隐神经髌下支于膝前方由内上向外下走行时和腘绳肌腱接近平行,因此在切取肌腱时可能对患者膝关节胫前皮肤感觉造成影响,改变切口方向可能减少对胫前皮肤感觉的影响。目的:探索膝关节前交叉韧带重建中使用不同方向切口切取腘绳肌腱对胫前皮肤感觉的影响。方法:收集于2013年7月至2014年2月膝关节前交叉韧带损伤患者74例,关节镜下使用患者自体腘绳肌腱修复重建膝关节前交叉韧带,根据切取肌腱时的切口方向,分为斜形切口组和纵形切口组,各37例。结果与结论:虽然两组患者取腱切口长度差异无显著性意义(P>0.05),但与纵行切口组相比,斜行切口组患者重建后2 d,重建1,3个月时胫前皮肤感觉减退面积明显缩小(P<0.05),但重建后6个月时2组患者胫前皮肤感觉障碍面积和膝关节lysholm评分差异无显著性意义(P>0.05)。提示关节镜下重建膝关节前交叉韧带时,2种切口产生的隐神经髌下支损伤对重建后近期胫前皮肤感觉及膝关节功能的影响接近。
BACKGROUND： Autologous hamstring tendon for anterior cruciate ligament reconstruction is the mainstream treatment of anterior cruciate ligament injury. When traveling from inside to outside and from top to bottom in the front of the knee, the patellar branch of the saphenous nerve runs parallel to the hamstring tendon. Therefore, to cut the tendon can lead to tibialis anterior skin sensitivity loss. To alter the incision direction may reduce the impact on the anterior tibial skin sensitivity. OBJECTIVE： To explore the influence of incisions in different directions for cutting the hamstring tendon on the anterior tibial skin sensitivity in anterior cruciate ligament reconstruction. METHODS： Seventy-four patients with anterior cruciate ligament injury admitted from July 2013 to February 2014 were enrolled. These patients underwent arthroscopic anterior cruciate ligament reconstruction using autologous hamstring tendon, and randomly divided into oblique incision group （n=37） and vertical incision group （n=37）. RESULTS AND CONCLUSION： There was no statistically significant difference in the incision length between the two groups （P 〉 0.05）. Compared with the vertical incision group, the area of skin sensitivity loss was smaller in the oblique incision group at 2 days, 1 month and 3 months after reconstruction （P 〈 0.05）, but after 6 months, there was no difference in the area of skin sensitivity loss and Lysholm scores between the two groups （P 〉 0.05）. These findings indicate that during anterior cruciate ligament reconstruction, the oblique and vertical incisions have similar effects on had no effect on postoperative recovery of anterior tibial skin sensitivity and knee function.
出处
《中国组织工程研究》
CAS
CSCD
2014年第51期8320-8324,共5页
Chinese Journal of Tissue Engineering Research
