LARS人工韧带与自体腘绳肌腱重建前交叉韧带的早期临床疗效比较

目的前瞻性对照研究LARS(ligament advanced reinforcementsystem)人工韧带与四股自体月国绳肌腱重建前交叉韧带(anterior cruciate ligament,ACL)手术的早期临床疗效。方法自2004年8月～2005年6月,共42例前交叉韧带损伤病例,根据LARS韧带使用指征,医生建议和患者意愿,选择自体月国绳肌腱或LARS人工韧带作为移植物。其中LARS韧带重建ACL病例23例,两端以挤压螺钉固定;四股自体月国绳肌腱重建前交叉韧带者19例,股骨端Endobutton悬吊固定,胫骨端Intrafix挤压螺钉和Spiked-washer拴桩双重固定。均在术前及术后3、6、9和15个月给予Lysholm、Tegner、IKDC评分。结果与自体月国绳肌腱重建ACL的病例比较,采用LARS韧带的病例,在术后平均9个月的随访期内,3种膝关节功能评分值高于自体月国绳肌腱A-CL重建的病例。结论应用LARS人工韧带的病例膝关节功能评分均较术前有明显提高。使用LARS人工韧带的病例较使用自体月国绳肌腱的病例术后膝关节功能恢复更早。

Comparison of early clinical outcome of ACL reconstruction and LARS artificial ligament and autologous hamstring tendon

Objective] To compare the ACL reconstructions with autogenous four-strand hamstring tendons,early clinical outcome of using the LARS artificial ligaments in anterior cruciate ligament(ACL) deficient knee were studied prospectively.Method] Forty-two cases of ACL injury were studied from April 2004 to June 2005.According to the indication of LARS ligament reconstruction,surgeon's suggestion and patient's aspiration,LARS artificial ligaments or autogenous hamstring tendons were chosen as grafts.Twenty-three cases with the LARS artificial ligaments were fixed by screw,and nineteen cases with autogenous hamstring tendons were fixed in formal tunnel by endobutton and in tibia tunnel by Intrafix screw plus Spiked-washer.Each patient was evaluated with Lysholm score,Tegner score and IKDC score pre-operative,3 months postoperative,6 months postoperative,9 months postoperative and 15 months postoperative,respectively.Results] Compared with the cases using autogenous hamstring tendons ACL reconstruction,the cases using the LARS artificial ligaments had higher score in the evaluation of knee functions within 9 months follow-up postoperative.Conclusion] The knee function scores are raised in cases using the LARS artificial ligaments ACL reconstruction.The knee functions of the patients,who use the LARS artificial ligaments recovered earlier than those using autogenous hamstring tendons in early stage.