关节镜下保留残端手术与常规手术重建前交叉韧带疗效比较

目的比较关节镜下保留残端手术与常规手术重建前交叉韧带(ACL)的疗效。方法采用关节镜下自体腘绳肌腱单束重建治疗66例膝关节ACL断裂患者,其中采用常规手术方法重建治疗37例,保留残端手术方法重建治疗29例。结果 66例均获随访,时间12~28个月。常规手术组及保留残端手术组术后前抽屉试验和Lachman试验比较差异均无统计学意义(P0.05);采用Lysholm、IKDC评分评价膝关节功能:两组术后比较差异均有统计学意义(P0.05),保留残端组优于常规手术组。结论关节镜下保留残端手术与常规手术行自体腘绳肌腱单束重建治疗膝关节ACL损伤都能获得满意的临床疗效,但关节镜下保留残端手术有利于移植物的再血管化及本体感受器的恢复。

Comparison of the effects between remnant preservation technique and routine method for anterior cruciate ligament reconstruction by arthroscopy

Objective To compare the effect between remnant preservation technique and routine method for anterior cruciate ligament （ ACL） reconstruction by arthroscopy. Methods Using autologous hamstring tendons for ACL re-construction by arthroscopy was applied in 66 patients of ACL injury. 37 cases received arthoscopic ACL reconstruc-tion through routine method, and 29 cases through remnant preservation technique. Results 66 patients were fol-lowed up for 12-28 months. According to anterior drawer test and Lachman test, there was no significantly difference between routine method group and remnant preservation technique group （P〉0. 05）. The differences of Lysholm and IKDC knee score between two groups were significantly different （P〈0. 05）,the remnant preservation technique were better than those of routine method group. Conclusions Using autologous hamstring tendons for ACL reconstruction by arthroscopy both has good clinical effect, and remnant preservation technique has the better effect for the angiogen-esis of graft and the rehabilitation of proprioceptive sense.