前交叉韧带单束重建和双束解剖重建短期临床疗效的病例对照研究

目的:比较关节镜下采用单束重建和双束重建前交叉韧带的临床效果。方法:自2009年1月至2010年5月,45例前交叉韧带撕裂患者分别行前交叉韧带解剖双束重建(双束重建组)和自体腘绳肌腱前交叉韧带单束重建(单束重建组)。双束组22例,男15例,女7例;年龄(27.04±3.68)岁;运动损伤3例,交通损伤19例。单束组18例,男13例,女5例;年龄(28.16±4.76)岁;运动损伤2例,交通损伤16例。按照IKDC、Lysholm膝关节评分标准及Lachman试验、轴移试验及KT-1000评估疗效。结果:双束重建组22例、单束重建组18例均获随访,时间12个月。单束重建组IKDC评分从术前(41.40±6.30)分提高至(95.70±3.10)分;Lysholm评分从(47.20±6.30)分提高至(94.20±2.40)分,双束重建组IKDC评分从术前(40.90±6.10)分提高至(96.10±3.40)分,Lysholm膝关节评分从术前(48.10±6.50)分提高至(95.10±2.49)分,两组差异无统计学意义。两组患者中均有1例Lachman试验I度阳性,1例轴移试验阳性。双束重建组KT-1000值(1.5±1.2)mm,单束重建组KT-1000值(1.9±1.5)mm,两组差异无统计学意义。结论:关节镜下采用单束重建和双束重建前交叉韧带临床疗效无明显差异。

Case-control study on clinical effects of arthroscopic single-versus double-bundle ACLs reconstructions

Objective:To compare the clinical results of arthroscopic single and double-bundle ACLs reconstructions. Methods:From January 2009 to May 2010,45 patients with anterior cruciate ligament tear were divided into two groups. In the first group,the anterior cruciate ligament were anatomical reconstructed with double-bundle semitendinous tendon,and in the second group the anterior cruciate ligaments were anatomical reconstrucated with single bundle semitendinous tendon. There were 22 patients(15 males and 7 females) in double-bundle group,with an average age of (27.04±3.68) years;18 patients(13 males and 5 females) in single bundle group,with an average age of (28.16±4.76) years. Therapeutic effects between two groups were compared according to the IKDC,Lysholm scoring standards and Lachman test,knee pivot shift test,KT-1000. Results:Twenty-two patients in double-bundle group and 18 patients in single-bundle group were followed-up,and the mean duration was 12 months. The IKDC score of patients in single-bundle group improved from preoperative 41.40±6.30 to postoperatively 95.70±3.10,Lysholm score increased from preoperative 47.20±6.30 to postoperative 94.20±2.40. And the IKDC score of patients in double-bundle group improved from preoperative 40.90±6.10 to postoperative 96.10±3.40,Lysholm score increased from preoperative 48.10±6.50 to postoperative 95.10±2.49. There was no statistically significant difference between the two groups. The Lachman test was positive in 2 patients(1 patient in double-bundle group and 1 patient in single-bundle group);and pivot shift test was positive in 2 patients(1 patient in double-bundle group and 1 patient in single-bundle group). KT-1000 of patients in double- bundle group was (1.5±1.2) mm,and (1.9±1.5) mm in single-bundle group,there were no statistically significant differences between the two groups. Conclusion:Arthroscopic single-bundle reconstruction and double-bundle anterior cruciate ligament reconstruction have no significant differences in clinical effects.