关节镜下重建前交叉韧带：单隧道双束与单束隧道重建的比较

背景：膝关节内前交叉韧带损伤后多采用关节镜下单束单隧道重建及双束双隧道重建，目前单隧道双束重建也已应用于临床，但具体疗效尚不明确。 目的：比较单隧道双束和单隧道单束重建前交叉韧带的临床疗效。 方法：在2007-03/2009-06选择21例前交叉韧带完全断裂患者接受关节镜下单隧道双束重建前交叉韧带手术，同期18例前交叉韧带完全断裂患者接受关节镜下单隧道单束重建前交叉韧带手术。两组患者均采用异体胫前肌进行重建前交叉韧带手术。采用国际膝关节文献委员会分级及Lysholm评分等评估两组患者重建疗效。 结果与结论：单隧道双束组随访12~25个月，平均(18.0±3.3)个月；单隧道单束组随访13~27个月，平均(19.8±3.6)个月。末次随访时单隧道双束组与单束组Lysholm评分平均分别为(87.0±2.2)分、(87.5±2.3)分，差异无显著性意义(P > 0.05)。说明单隧道双束和单隧道单束重建前交叉韧带的临床疗效差异无显著性意义，单隧道双束重建前交叉韧带也是一种可靠的前交叉韧带重建方法。

Arthroscopic reconstruction of anterior cruciate ligaments: Single-tunnel double-bundle versus single-tunnel single-bundle

BACKGROUND:Arthroscopic reconstruction of anterior cruciate ligament (ACL) commonly adapted single-tunnel single-bundle or double-tunnel double-bundle methods. Though single-tunnel double-bundle has been used in the clinic, the curative effect remains unclear.   OBJECTIVE:To compare the clinical results of ACL reconstruction using the single-tunnel double-bundle and single-tunnel single-bundle.   METHODS:From March 2007 to June 2009, 39 patients with ACL rupture underwent arthroscopic single-tunnel double-bundle reconstruction (21 cases) or single-tunnel single-bundle reconstruction (18 cases). They both used anterior tibialis tendon allograft to reconstruct the ACL. Their clinical result was compared in terms of International Knee Documentation Committee (IKDC) and Lysholm scores.   RESULTS AND CONCLUSION:The follow-up periods ranged from 12 to 25 months, mean (18.0±3.3) months, for the single-tunnel double-bundle group, and from 13 to 27 months, mean (19.8±3.6) months, for the single-tunnel single-bundle group. The Lysholm of the single-tunnel double-bundle group and single-tunnel single-bundle group were (87.0±2.18) and (87.5±2.33) scores, and the difference had no significant (P > 0.05). Since there are no significant differences between two groups in clinical outcome, the single-tunnel double-bundle ACL reconstruction is a reliable method for ACL reconstruction.