文章摘要
胡岚翔,余化龙,刘亚东,等.自体骨-髌腱-骨移植与半腱肌腱联合股薄肌腱重建前交叉韧带的疗效比较.骨科,2018,9(2): 123-126.
自体骨-髌腱-骨移植与半腱肌腱联合股薄肌腱重建前交叉韧带的疗效比较
Comparison of autologous bone-patellar tendon (middle 1/3)-bone autograft and autologous semitendinosus and gracilis muscle in the reconstruction of anterior cruciate ligament
投稿时间:2017-07-26  
DOI:10.3969/j.issn.1674-8573.2018.02.008
中文关键词: 膝关节  关节镜检查  前十字韧带重建
英文关键词: Knee joint  Arthroscopy  Anterior cruciate ligament reconstruction
基金项目:十堰市科学技术研究项目(14Y50)
作者单位E-mail
胡岚翔 442000 湖北十堰湖北医药学院附属东风医院手足外科  
余化龙 442000 湖北十堰湖北医药学院附属东风医院手足外科 yuhualong65@163.com 
刘亚东 442000 湖北十堰湖北医药学院附属东风医院手足外科  
陈虎 442000 湖北十堰湖北医药学院附属东风医院手足外科  
刘志刚 442000 湖北十堰湖北医药学院附属东风医院骨科  
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中文摘要:
      目的 对比膝关节镜下自体骨-髌腱(中1/3)-骨(B-PT-B)移植与自体半腱肌腱及股薄肌腱移植两种治疗方式在重建前交叉韧带中的临床疗效。方法 回顾性分析2009年11月至2016年6月我科收治的前交叉韧带损伤病人89例,男60例、女29例,年龄为35~45岁,平均(42.21±2.32)岁,左膝66例,右膝23例。根据手术方式不同分为:①行膝关节镜下B-PT-B移植组(B-PT-B组)40例,男28例、女12例,年龄为35~45岁;②行自体半腱肌腱与股薄肌腱移植组(肌腱组)49例,男32例、女17例,年龄为35~45岁。两组病人一般资料比较,差异均无统计学意义(均P>0.05)。记录并比较两组病人术前及术后3、6、9、12个月Lysholm评分,根据膝关节轴移试验与Lanchmann试验评定病人膝关节稳定性。结果 89例病人均获得随访,随访时间为13~20个月,平均16个月。术后3个月B-PT-B组Lysholm评分优良率优于肌腱组,差异有统计学意义(χ2=4.385,P=0.030)。术后6、9个月,两组间优良率比较,差异无统计学意义(均P>0.05)。术后12个月B-PT-B组优良率低于肌腱组,差异有统计学意义(χ2=9.237,P=0.038)。两组病人术后均一期痊愈,愈合时间为2~8个月,平均(4.53±1.30)个月。结论 采用自体半腱肌腱和股薄肌腱术式病人远期预后水平更佳,膝关节功能恢复更快。
英文摘要:
      Objective To compare the clinical efficacy of autogenous bone-condylar (middle 1/3)-bone (B-PT-B) transplantation vs. autogenous semitendinosus and gracilis tendon transplantation in the reconstruction of anterior cruciate ligament. Methods Eighty-nine patients with anterior cruciate ligament injury treated in our department between November 2009 and June 2016 were retrospectively analyzed. There were 60 males and 29 females, aged 35-45 years, with the average of (42.21±2.32) years old. There were 66 cases of left knee injury and 23 cases of right knee injury. All patients were classified according to the different surgical methods: 40 cases in the B-PT-B transplantation group (B-PT-B group) (28 males and 12 females, aged 35-45 years old); 49 cases in autograft semitendinosus and gracilis tendon transplantation group (tenascus group) (32 males and 17 females, aged 35-45 years). There was no significant difference in the general data between the two groups (all P>0.05). The Lysholm scores preoperation and at 3rd, 6th, 9th, and 12th month post-operation in the two groups were recorded and compared. The knee joint stability was assessed according to the knee joint displacement test and the Lanchmann test. Results All 89 patients were followed up for 13 to 20 months with an average of 16 months. At 3rd month after surgery, the excellent rate of Lysholm score in B-PT-B group was significantly higher than that in tenascus group (χ2=4.385, P=0.030). At 6th and 9th month after operation, there was no significant difference between the two groups (all P>0.05). At 12th month post-operation, the excellent rate in B-PT-B group was significantly lower than that in tenascus group (χ2=9.237, P=0.038). The patients in both groups were cured at the first stage and the healing time was 2-8 months with an average of (4.53±1.30) months. Conclusion Patients with autogenous semitendinosus and gracilis tendon have better long-term prognosis and faster knee function recovery.
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