两种股骨端固定方法重建前交叉韧带疗效观察

目的 探讨关节镜下股骨端两种不同方法固定同种异体肌腱重建前交叉韧带的临床效果.方法 自2009年4月至2012年3月行同种异体肌腱重建前交叉韧带患者30例,胫骨端均采用可吸收挤压螺钉固定,根据股骨端不同固定方法分为两组:Ⅰ组为可吸收挤压螺钉组,共15例,男11例,女4例,年龄24～39岁,平均26.8岁；Ⅱ组为悬吊钢板组,共15例,男10例,女5例,年龄23～42岁,平均27.2岁.术前及术后进行前抽屉试验、Lachman试验、Lysholm膝关节评分观察临床效果.结果 经过6～20个月随访,两组患者的前抽屉试验及Lachman试验结果均转为阴性.Ⅰ组Lysholm膝关节评分由重建前(53.30±5.20)分增长到重建后(91.20±6.20)分,经t检验,差异有统计学意义(P＜0.05)；Ⅱ组患者Lysholm膝关节评分由重建前(56.25±6.20)分增长到重建后(93.00±4.60)分,经t检验,差异有统计学意义(P＜0.05)；Ⅰ组与Ⅱ组重建后Lysholm膝关节评分差异无统计学意义(P＞0.05).结论 两种方法均固定可靠,近期疗效满意,目前并不能得出孰优孰劣的结论,远期疗效有待进一步观察.

Clinical Observation after Two Kinds of Femoral Fixed Method in Anterior Cruciate Ligament Reconstruction

Objective To retrospectively discuss clinical results between two kinds of femoral fixed method after arthroscopic ACL reconstruction with allogeneic tendon. Methods Thirty patients were treated with arthroscopic ACL reconstruction respectively using allogeneic tendon from April 2009 to March 2012. Absorbable interference screws were used in tibia and fixation. And the patients were divided into tow groups according to the femoral fixation method： I . Absorbable Interference Screw group, Ⅱ . Retrobutton group. Patients were evaluated by the anterior drawer test,Lachman test,Lysholm score. Results The follow-up period of two groups was 6 to 20 months,the post- operative anterior drawer test result and Lachman test result both become negative. The Lysholm scores of I group were increased from preoperative （53.30± 5.20） to postoperative （91.20±6.20）,which showed significant differences in t-test（P〈0.05）. The Lysholm scores of Ⅱ group were increased from preoperative（56.25±6.20） to postoperative （93.00 ± 4. 60）, which showed significant differences in t-test （P〈0. 05）;There were no significant differences in postoperative Lysholm scores between two groups （P〉0.05）. Conclusion Two kinds of fixed method are reliable, and short-term effect is satisfactory. At present we cannot come to the conclusion,which is better or worse ,a forward curative effect remains to be further observation.