关节镜下4种移植物重建膝关节前交叉韧带的临床效果研究

目的应用自体骨-1/3髌腱-骨(B-PT-B)、自体腘绳肌腱(ST/G)、同种异体跟腱和LARS韧带进行关节镜下重建前交叉韧带,比较不同移植物的临床疗效。方法选择4种不同移植物分别对111例交叉韧带损伤患者行关节镜下重建前交叉韧带,术后积极康复训练。结果各组膝关节Lysholm评分在术后3、6、12、18个月均较术前改善,异体跟腱组在术后6个月Lysholm评分均低于其余3组患者(P<0.05),术后12、18个月与自体B-PT-B、ST/G组差异无统计学意义;在术后3、6、12、18个月,LARS组Lysholm评分明显高于其余3组(P<0.05)。结论4种不同移植物均能明显改善膝关节功能,近期LARS韧带改善优于自体B-PT-B、ST/G和异体跟腱。

Cornparatiive study on anterior Cruciate.ligament arthroscopic reconstructiion with four different grafts

Objective To compare clinical effects with anterior cruciate ligament arthroscopic reconstruction with bone-patellar tendon-bone(BTB) autograft,quadruple hamstring tendon(HT) autograft,achilles tendon bone allograft and ligament advancement reinforcement system(LARS) artificial ligaments.MethodsFrom Feb.2001 to Dec.2006,a total of 111 patients suffered from anterior cruciate ligament rupture underwent reconstruction with four different grafts and followed by accelerated rehabilitation program.ResultsThe function of knee joint was all improved in 3,6,12 and 18 month postoperatively.There was significant difference that Lysholm score of achilles tendon bone allograft group was lower than that in the other groups in 6 month postoperatively(P<0.05),and no significant difference was found among B-PT-B group and ST/ G group in 12 and 18 month postoperatively(P>0.05).The Lysholm score of LARS group was significantly increased,comparing with the other groups in 3,6,12 and 18 month postoperatively(P<0.05).ConclusionThe function of knee joint can be obviously improved in ACL arthroscopic reconstruction with BTB,quadruple ST/ G,achilles tendon bone allograft,and LARS artificial ligaments.The LARS artificial ligaments have an advantage in improving the function of knee joint in the near future.