前十字韧带重建中两种移植物的选择对临床效果的影响

目的探讨自体、异体人工移植物重建膝关节前十字韧带（ACL）的临床效果。方法回顾性分析我院2004年4月～2010年2月收治入院的ACL断裂患者60例临床资料,将采用关节镜下自体骨-髌腱-骨（B-PT-B）重建ACL患者30例设为A组,将采用关节镜下异体B-PT-B重建ACL患者30例设为B组,两组手术方法相同。观察两组患者术后红细胞沉降、C反应蛋白及体温变化情况,并用KT-2000、BiodexIKDC、Tegner、Lysholm等方法评估手术效果及肌力恢复情况并进行对比分析。结果随访30～55个月,两组发热天数、术后第6天红细胞沉降率和C反应蛋白等比较差异均无统计学意义（均P〉0.05）;A组膝前痛21例（70.0%）,明显高于B组13例（43.33%）;髌股关节压痛B组为18例（60.0%）,A组28例（93.33%）,差异均有统计学意义（均P〈0.05）;两组患者IFDC评分、Lyshom评分、Tegner评分、大腿围度差值、KT-2000前移距离、Biodex等速肌力测试结果比较,差异均无统计学意义（均P〉0.05）。结论自体和异体移植物在术后均需要经历再血管化和韧带化,使得移植物强度在术后早期不足。

Clinical effects of two graft selection in anterior cruciate ligament reconstruction

Objective To investigate the clinical effect of autologous,allogeneic graft reconstruction of anterior cruciate ligament(ACL).Methods Clinical data of 60 cases of patients with ACL rupture in our hospital from April 2004 to February 2010 were analyzed retrospectively,30 cases of patients were given arthroscopic ACL reconstruction with autogenous bone-patellar tendon-bone(B-PT-B)(group A),and 30 cases of patients were given arthroscopic ACL reconstruction with allogenic B-PT-B(group B).The postoperative erythrocyte sedimentation,C-reactive protein and body temperature changes were observed,And KT-2000,BiodexIKDC,Tegner,Lysholm and other methods were used to assess the effect of surgery and postoperative muscle recovery.Results The follow-up time was 30-55 months,the fever days,erythrocyte sedimentation rate on the sixth day after operation and C-reactive protein of two groups were found no statistically significant differences(P > 0.05);anterior knee pain in group A [21(70.00%)]were found more than those in group B [13(43.33%)];patellofemoral joint tenderness in group A [28(93.33%)] were found more than those in group B [18(60.00%)];the differences were all statistically significant(all P < 0.05).The differences of IFDC score,Lyshom score,Tegner score,thigh circumference difference,KT-2000 forward distance and Biodex isokinetic muscle strength test results of the two groups were all not statistically significant(all P > 0.05).Conclusion The autologous and allogeneic graft all need to undergo revascularization and ligaments after surgery,and then make the graft strength lack in the early postoperative period.