关节镜下异体与自体肌腱联合编织重建前交叉韧带疗效研究

目的观察自体胭绳肌肌腱与同种异体移植物关节镜下重建膝关节前交叉韧带(ACL)的疗效。方法回顾性分析我院2006年2月~2010年6月收治入院的自体胭绳肌肌腱与同种异体移植物关节镜下重建膝关节前交叉韧带(ACL)患者30例临床资料,均采用美国强生公司生产的Rigidfix及Intrafix系统固定,评价项目包括手术时间、发热天数、大腿周径患健侧比值、Lachman试验、中立位前抽屉试验(ADD)和国际膝关节评分委员会(IKDC)评分、Lysholm及Tegner评分。随访时间为12～24个月。结果 30例患者术后膝关节稳定性均得到明显好转;手术前后大腿周径患健侧比值、IKDC评分、lysholm评分及Tegner评分等指标比较差异均有统计学意义(P<0.05);随访(14.5±2.3)个月,膝前区疼痛5例,手术感染性关节炎1例,给予抗生素及激素治疗1个月后痊愈。术后随访发现肌腱没有免疫排斥反应。结论自体胭绳肌肌腱与同种异体移植物联合关节镜下重建膝关节前交叉韧带有较好的疗效。

Clinical effect study on reconstruction of anterior cruciate ligament with allo-autologous tendon grafts under arthroscopy

Objective To observe therapeutic effects for reconstruction of anterior cruciate ligament（ACL） with alto-ham string tendon and antologous tendon grafts under arthroscopy.Methods The clinical data of 30 patients with reconstruction of anterior cruciate ligament（ACL） with alto-hamstring tendon and antologous tendon grafts under arthroscopy were col lected and analyzed retrospectively in our hospital from February 2006 to June 2010.All cases were fixed by Rigidfix and Intrafix system of Johnson Johnson production.Evaluation project included the operation time,the duration of fever,the ratio of thigh diameter between paretic and non paretic side,Lachman test,neutral anterior drawer test（ADD）,Lysholm,Tegner and international knee documentation committee（IKDC） scores.All had been followed up for 12 to 24 months.Results Knee stability of 30 patients was improved obviously after operation.The the ratio of thigh diameter between paret ic and non paretic side,Lysholm score,IKDC score and Tegner score had statistically significant compared to pre-opera tion（P〈0.05）.The follow-up had been sustained for（14.5 ±2.3） months.5 cases with knees area pain and 1 case with surgery infectious arthritis were occurred,and they were recovered after 1 month by treament with antibiotics and hormone.None was found immune rejection on tendon for the follow-up period.Conclusion Reconstruction of anterior cruciate ligament with allo-autologous tendon grafts under arthroscopy has good curative effect.