关节镜下同种异体韧带重建前交叉韧带的临床研究

目的探讨关节镜下应用同种异体肌腱重建膝关节前交叉韧带的近期和远期效果。方法自2002年1月～2003年1月,对7例前交叉韧带断裂患者(全部为男性,平均年龄42.0岁)应用深低温同种异体胫前肌腱重建断裂的前叉韧带,术后指导患者行功能锻炼。采取IKDC(国际膝关节评分委员会)功能评分、Lysholm评分、Tengner评分标准对患者术前,术后8个月,术后6年膝关节主观功能评分;采用KT2000在屈膝30°、90°,134N下分别测量患者术前,术后8个月,术后6年胫骨前后移动的距离。结果 7例均获随访,随访达6～7年,平均6.5年。患者术前与其他两组(术后8个月和术后6年)IKDC、Lysholm、Tengner评分比较,差异均有统计学意义(P0.05)。术后8个月、术后6年之间三种评分比较,差异均没有统计学意义(P0.05);KT2000屈膝30°、90°,134N下胫骨前后移动距离,术前和其他两组(术后8个月和术后6年)之间比较,差异均有统计学意义(P0.05),而术后8个月和术后6年之间比较,差异均没有统计学意义(P0.05)。所有患者无出现重建的前交叉韧带再断裂现象。结论同种异体肌腱能简单有效地重建膝关节前叉韧带。正确选取韧带和适当推迟康复进程是确保疗效的要点之一。

Arthroscopic allogenic ligament transplantation for anterior cruciate ligament Reconstruction

Objective To assess the clinical efficacy of allogenic ligament transplantation for anterior cruciate ligament（ACL） reconstruction by arthroscopy.Methods Seven patients with ACL injury treated with allogenic anterior tibialis tendon reconstruction by arthroscopy were selected from January 2002 to January 2003.There were seven males in the group,with an average age of 42.0 years.The function of knee joint was assessed by IKDC score,Tengner score and Lysholm knee score before transplantation,eight months after transplantation and six years after transplantation.The stability and the motion range of knee joint were assessed by KT-2000 testing.Results A six to seven years follow-up was carried out.All patients didn＇t suffer from ACL injury again.The IKDC score,Tengner score and Lysholm knee score of eight months,or six years after transplantation were significantly better than that before transplantation（P 0.05D）.The IKDC scores of these three tests were not significantly different between 8-month-postoperation and 6-year-postoperation（P 0.05）.The KT-2000 testing also had no significant difference between the 8-month-postoperation and the 6-year-postoperation.Conclusions The mid-term and long-term follow-up showed that the arthroscopic allogenic transplantation for ACL reconstruction had a satisfied clinical efficacy with safety.In order to achieve successes,one of the key points is to select good tendon and postpone the rehabilitation plan.