自体四股胭绳肌腱单束与双束重建前交叉韧带临床疗效的对比研究

目的探讨关节镜下自体四股胭绳肌腱单束与双束重建前交叉韧带的临床疗效。方法2006年3月～2009年11月在关节镜下采用自体四股胭绳肌腱重建前交叉韧带46例，其中单束组26例，双束组20例，分别于术后3、6、12、18个月随访，比较2组膝关节稳定性，并按照IKDC膝关节评分标准进行疗效评价。结果末次随访（术后18个月）：双束组IKDC主观评分（89．2±4．5）分与单束组（85．7±4．9）分有统计学性差异（t=2．539，P=0．015），2组前抽屉试验、Laehman试验阳性率均无统计学差异[7．7％（2／26）VS．0（0／20），P=0．498；30．8％（8／26）VS．15．0％（3／20），x2=1．878，P=0．391]。结论关节镜下白体四股胴绳肌腱单束与双束重建前交叉韧带均具有膝关节前向稳定性好等优点，但双束重建前交叉韧带膝关节主观评分优于单束重建。

Clinical Comparison of Single and Double-bundle Anterior Cruciate Ligament Reconstruction with Four-stand Hamstring Antograft

Objective To compare the clinical effect of single-bundle versus double-bundle arthroscopic reconstruction of anterior crueiate ligament （ACL） with four-stand hamstring antograft. Methods From March 2006 to November 2009, 46 cases of ACL rupture were treated by arthroscopic reconstruction with four-stand hamstring antograft, including 26 cases of single-bundle hamstring tendon （ single-bundle group）, and 20 cases of double-bundle hamstring tendon （ double-bundle group ）. All cases were followed up 3, 6, 12 and 18 months after operation. The stability of knee and IKDC scores were compared between the two groups. Results At the final follow-up, IKDC subjective scores in double-bundle group were significantly higher than those of the singlebundle group [ （ 89.2 ±4.5 ） points vs. （85.7 ± 4.9） points, t = 2. 539,P = 0.015 ] ; no significant difference was found between the two groups in anterior drawer test and Lachman test [7.7% （2/26） vs. 0（0/20） ,P = 0.498 ;30.7% （8/26） vs. 15% （3/20）,x2 = 1. 878,P = 0. 391 ]. Conclusions Arthroscopic single-bundle and double-bundle reconstruction of ACL with four-stand hamstring antograft have the advantage of better foreward stabihty of the knee. Double-bundle ACL reconstructions show better subjective IKDC scores than single-bundle.