摘要
背景:ACL损伤的重建分为双束重建和单束重建两类,双束重建稳定性优于单束解剖重建,但关于胫骨单骨道双束自体肌腱重建技术和临床效果的研究报道较少。目的目的:探讨关节镜下胫骨单骨道双束重建前交叉韧带的临床价值。方法方法:根据入院单双号顺序将2013年1月至2014年8月收治的24例初次前交叉韧带断裂患者分为单束组和双束组,每组12例,分别采用关节镜下单骨道单束和双骨道双束重建前交叉韧带。移植物采用自体腘绳肌。比较两组患者术前、术后的膝关节Lysholm评分、国际膝关节文献委员会膝关节评估量表评分(IKDC)及患者屈膝30°和90°的134N拉力情况下胫骨前移度的KT-2000值,及末次随访的美国纽约特种外科医院(HSS)膝关节功能评价。结果结果:两组间膝关节Lysholm评分在术前,术后第6个月、12个月比较差异不具有统计学意义(P>0.05),但两组术后第6、12个月的Lysholm评分较术前均显著提高(P<0.05)。术前单束组和双束组的IKDC评分无显著统计学差异(P>0.05),末次随访时双束组的IKDC评分显著高于单束组(P<0.05)。手术前后两组的KT-2000值组间比较差异均不具有统计学意义(P>0.05),而术后两组的KT-2000值均较术前显著降低(P<0.05)。末次随访时单束组和双束组的膝关节HSS评定优良率分别为83.33%和91.67%,组间比较无显著统计学差异(P>0.05)。结论结论:关节镜下胫骨单骨道双束重建前交叉韧带疗效和单骨道单束手术方式相近,但双束法的稳定性较单束法更高。
Background：Anterior cruciate ligament （ACL） reconstruction includes double-bundle and single-bundle reconstruction, and the stability of double-bundle is better than single-bundle operation. But there are few reports on tibial single tunnel double-bundle autogenous tendon reconstruction. Objective：To investigate therapeutic effect of arthroscopic tibial single bone tunnel double-bundle ACL reconstruction. Methods：According to the odd and even number order, 24 patients who suffered from ACL rupture and were admitted to our hospital from January 2013 to August 2014, were divided into two groups. There were 12 patients in each group. ACL was reconstructed by arthroscopic single-bundle and double bone tunnel double-bundle methods, respectively. Grafts were all autologous hamstring. The knee joint Lysholm score, International Knee Documentation Committee （IKDC） of knee joint assessment scale score, KT-2000 measurement under 134N tensile force for flexion （30° and 90° ） were recorded and compared between two groups. Knee joint function was evaluated by America New York Hospital for Special Surgery （HSS） knee joint score at the final follow up. Results：There was no significant difference in Lysholm score between the two groups before surgery, at 6 months and 12 months after surgery （P〉0.05）. Lysholm score at 6 months and 12 months after surgery was significantly higher than preoper-ative one in both two groups （P〈0.05）. There was no significant difference in preoperative IKDC score between the two groups （P〉0.05）, while IKDC score in double-bundle group was significantly higher than that in single-bundle group （P〈0.05）. There was no significant difference in KT-2000 value between two groups preoperatively or postoperatively （P〉0.05）, but postoperative KT-2000 value was significantly lower than preoperative one in both groups （P〈0.05）. The excellent-and-good rate of HSS knee joint evaluation was 83.33%in single-bundle group and 91.67%in double-bundle group （P〉0.05）.Conclusions：The efficacy of arthroscopic tibial single bone tunnel double-bundle anterior cruciate ligament reconstruction is similar to single bone single-bundle operation mode. But the stability of double-bundle is better than single-bundle operation.
出处
《中国骨与关节外科》
2015年第2期125-129,共5页
Chinese Journal of Bone and Joint Surgery
基金
2013年东莞市医疗卫生科技计划一般项目(项目编号:20131051010075)
关键词
关节镜
胫骨单骨道双束
重建前交叉韧带
单骨道单束
腘绳肌
Arthroscopy
Tibial single bone tunnel double-bundle
Anterior cruciate ligament reconstruction
Single bone tunnel single-bundle
Hamstring
