同种异体胫前肌腱与自体腘绳肌腱重建前交叉韧带的病例对照研究

目的：对比异体胫前肌腱与自体胭绳肌腱重建前交叉韧带的临床疗效。方法：2005年9月至2007年5月，重建前交叉韧带100例，其中50例采用经深低温冷冻及v射线照射处理后的畀体胫前肌腱重建，50例采用自体胭绳肌腱重建。固定方式均为股骨端横杆悬挂固定（Rigidfix）和胫骨端中心固定（Intrafix）。术后通过对比两组症状体征、Lysholm评分来对比疗效。结果：两组均顺利完成手术，无感染及韧带再断裂发生。所有患者术后获随访，时间12-33个月（平均25．6个月）。异体组50例术膝轴移试验均阴性，前抽屉试验及Lachman试验为阴性或I度阳性；术后1年以上Lrrsholm总评分平均（89．3±6．3）分。自体组50例术膝体征检查结果与异体组类似，术后1年Lysholm总评分平均（90．5±4．5）分，两组对比差异无统计学意义（P〉0．05）。结论：同种异体胫前肌腱与自体胭绳肌腱重建前交叉韧带疗效相当，医生及患者可根据实际情况选择移植物。

Comparison of the clinical outcome of anterior cruciate ligament reconstruction using allograft anterior tibialis and autologous hamstring tendon

Objective: To compare the clinical outcomes of ACL reconstruction using allograft anterior tibialis and autologous hamstring tendon. Methods: From September 2005 to May 2007,100 ACLs were reconstructed,allograft were inplanted in 50 patients and autograft 50 patients. Rigidfix and Intrafix were used for graft fixation. The symptoms and objective signs were compared between two groups. Lysholm score were used for outcome evaluation. Results: There were neither infection nor rupture of the reconstructed ACLs in all patients. All patients were followed and the average follow-up period was 25.6 months (range 12 to 33). There was no positive pivot shift sign in two groups,the anterior drawer test (ADT)and Lachman test were negative or grade I positive. There was no difference in Lysholm scores between two groups(89.3 allograft vs. 90.5 autograft,P>0.05). Conclusion: These data suggest that there are no differences in clinical outcomes of ACL reconstruction with allograft anterior tibialis tendon and autologous hamstring tendon.