摘要
背景:自体肌腱移植重建膝关节前交叉韧带已广泛应用,但是供区容易出现并发症,现今膝关节前交叉韧带重建越来越多的应用同种异体肌腱移植,同种异体肌腱已经成为一种重要的替代材料。目的:观察关节镜下同种异体肌腱移植重建膝关节前交叉韧带的临床疗效及免疫排斥反应。方法:膝关节前交叉韧带损伤患者120例,按随机数表法随机分为自体肌腱组及异体肌腱组,每组各60例。自体肌腱组植入患膝同侧的股薄肌腱+半腱,异体肌腱组植入同种异体肌腱前交叉韧带重建。随访2年,观察两组患者治疗前后Lachman试验结果、Lysholm和Larson评分及免疫排斥反应发生情况。结果与结论:①两组韧带韧带重建后2年Lysholm评分和Larson评分均显著高于重建前,两组重建2年后Lysholm评分、Larson评分比较差异无显著性意义(P>0.05);②两组病例末次随访时,膝关节活动度均恢复至正常,无伸膝滞缺、屈膝受限;③两组Lachman试验末次随访时组间差异无显著性意义(P>0.05);④异体肌腱移植免疫排斥反应出现的比率与自体肌腱移植比较差异无显著性意义(P>0.05),但整体趋势上免疫排斥反应出现的比率比自体肌腱重建组高;⑤结果说明,与自体肌腱重建前交叉韧带相比较,同种异体肌腱有着相似的临床疗效,且免疫排斥反应不大,临床上可根据患者的病情及主观要求灵活选择。
BACKGROUND： Problems can occur at the donor site where the autologous tendon graft is taken. Allogenic tissue has become an important graft option for the reconstruction of the anterior cruciate ligament. OBJECTIVE： To study the clinical curative effect and immune rejection of arthroscopic reconstruction of the anterior cruciate ligament by allogeneic tendon graft. METHODS： The 120 included patients with anterior cruciate ligament injury were randomized into autologous tendon graft and allogeneic tendon graft groups, respectively, with 60 patients in each group. The autologous semitendinosus-gracilis graft at the affected side or the allogeneic anterior cruciate ligament was implanted into the knee joint in autologous tendon graft group or allogeneic tendon graft group, respectively. Lachman test results, Lysholm and Larson scores of joint function, and postoperative immune rejection were observed and assessed during 2-year follow-up. RESULTS AND CONCLUSION： Lysholm and Larson scores in autologous tendon graft and allogeneic tendon graft groups were significantly increased after the reconstruction compared with before the reconstruction; however, there was no difference in the scores between both two groups at 2 years after the reconstruction（P〉0.05）. At the end of the follow-up, the normal function of the knee joint was restored, and no lag and flexion constraint of the knee joint were observed. No significant differences were observed in Lachman test results between both groups（P〉0.05）. Compared with the autologous tendon graft group, immune rejection rates were higher in the allogeneic tendon graft group; however, no significant differences were observed between both groups（P〉0.05）. In summary, the allogeneic tendon graft may be a candidate for the reconstruction of the anterior cruciate ligament due to its similar clinical curative effect to the autologous tendon graft and low immune rejection rates.
出处
《中国组织工程研究》
CAS
北大核心
2016年第15期2190-2196,共7页
Chinese Journal of Tissue Engineering Research
基金
佛山市卫生局科研立项(2011135)~~
