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[1]程松苗,胡勇,陳君蓉,等.Rigidfix橫穿釘固定移植肌腱脛骨端重建前交叉韌帶的臨床研究[J].中醫(yī)正骨,2020,32(08):12-16.
　CHENG Songmiao,HU Yong,CHEN Junrong,et al.A clinical study of fixation of tibial end of transplanted tendon with Rigidfix cross-pins in surgery of anterior cruciate ligament reconstruction[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(08):12-16.
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Rigidfix橫穿釘固定移植肌腱脛骨端重建前交叉韌帶的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年08期
頁碼:
12-16
欄目:
臨床研究
出版日期:
2020-08-20

文章信息/Info

Title:
A clinical study of fixation of tibial end of transplanted tendon with Rigidfix cross-pins in surgery of anterior cruciate ligament reconstruction
作者:
程松苗; 胡勇; 陳君蓉; 陳鵬旭; 蔣旭; 李強; 孫敏
(四川省骨科醫(yī)院,四川 成都 610041)
Author(s):
CHENG Songmiao; HU Yong; CHEN Junrong; CHEN Pengxu; JIANG Xu; LI Qiang; SUN Min
Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China
關(guān)鍵詞:
前交叉韌帶重建;  腱固定術(shù);  Rigidfix橫穿釘;  臨床試驗
Keywords:
anterior cruciate ligament reconstruction;  tenodesis;  Rigidfix cross pin;  clinical trial
摘要:
目的:探討Rigidfix橫穿釘固定移植肌腱脛骨端重建前交叉韌帶的臨床療效和安全性。方法:回顧性分析99例采用自體腘繩肌肌腱重建前交叉韌帶(anterior cruciate ligament,ACL)患者的病例資料,其中移植肌腱脛骨端采用Rigidfix橫穿釘固定50例(橫穿釘固定組)、采用Intrafix界面螺釘固定49例(界面螺釘固定組)。比較2組患者的手術(shù)時間、術(shù)后至完全負重行走時間、Lysholm評分、國際膝關(guān)節(jié)文獻委員會(International Knee Documentation Committee,IKDC)膝關(guān)節(jié)評分、脛骨隧道內(nèi)口擴大值及并發(fā)癥發(fā)生情況。結(jié)果:2組患者的手術(shù)時間、術(shù)后至完全負重行走時間比較,組間差異均無統(tǒng)計學(xué)意義[(55.3±5.3)min,(53.5±4.3)min,t=1.891,P=0.062;(19.0±5.1)d,(18.3±3.8)d,t=0.741,P=0.461]。所有患者均獲得隨訪,隨訪時間24～35個月,中位數(shù)33個月。切口均甲級愈合。2組患者術(shù)后1年Lysholm評分、IKDC膝關(guān)節(jié)評分比較,組間差異均無統(tǒng)計學(xué)意義[(90.4±1.7)分,(90.9±1.7)分,t=-1.575,P=0.118;(86.0±3.2)分,(86.1±2.9)分,t=-0.069,P=0.945]。脛骨隧道內(nèi)口擴大值,橫穿釘固定組低于界面螺釘固定組[(1.49±0.11)mm,(2.52±0.17)mm,t=-36.488,P=0.000]。橫穿釘固定組2例出現(xiàn)橫穿釘穿出骨皮質(zhì),界面螺釘固定組25例出現(xiàn)螺釘偏移骨隧道,均未做處理,隨訪期間未見異常。均無膝關(guān)節(jié)僵硬、神經(jīng)血管損傷、膝關(guān)節(jié)感染等并發(fā)癥發(fā)生。橫穿釘固定組的并發(fā)癥發(fā)生率低于界面螺釘固定組(χ2=27.585,P=0.000)。結(jié)論:采用自體肌腱重建ACL時,移植肌腱脛骨端采用Rigidfix橫穿釘固定和Intrafix界面螺釘固定的短期臨床療效相當(dāng),但Rigidfix橫穿釘固定安全性更高。
Abstract:
To explore the clinical curative effects and the safety of fixation of tibial end of transplanted tendon with Rigidfix cross-pins in surgery of anterior cruciate ligament reconstruction(ACLR).Methods:The medical records of 99 patients who received ACLR with autologous hamstring tendon were analyzed retrospectively.The tibial end of transplanted tendon was fixed with Rigidfix cross-pins in 50 patients(cross-pin fixation group)and Intrafix interference screw in 49 patients(interference screw fixation group)respectively.The operative time,postoperative full weight-bearing walking start time,Lysholm scores,International Knee Documentation Committee(IKDC)knee scores,enlarged value of tibial tunnel entrance and complication incidences were compared between the 2 groups.Results:There was no statistical difference in operative time and postoperative full weight-bearing walking start time between the 2 groups(55.3+/-5.3 vs 53.5+/-4.3 min,t=1.891,P=0.062; 19.0+/-5.1 vs 18.3+/-3.8 days,t=0.741,P=0.461).All patients in the 2 groups got primary healing in the surgical incisions and all patients in the 2 groups were followed up for 24-35 months with a median of 33 months.There was no statistical difference in Lysholm scores and IKDC knee scores between the 2 groups at 1 year after the surgery(90.4+/-1.7 vs 90.9+/-1.7 points,t=-1.575,P=0.118; 86.0+/-3.2 vs 86.1+/-2.9 points,t=-0.069,P=0.945).The enlarged values of tibial tunnel entrance were lower in cross-pin fixation group compared to interference screw fixation group(1.49+/-0.11 vs 2.52+/-0.17 mm,t=-36.488,P=0.000).The cross-pin punched out of the bone cortex in 2 patients in cross-pin fixation group,and the screw deviated from tibial tunnel in 25 patients in interference screw fixation group.No special treatment was performed and no abnormalities were found during the follow-up period.No complications such as knee joint stiffness,neurovascular injury and knee arthrosis infection were found in the 2 groups.The incidence rate of complications was lower in cross-pin fixation group compared to interference screw

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備注/Memo

備注/Memo:
基金項目:四川省衛(wèi)生和計劃生育委員會科研課題(16PJ388) 通訊作者:陳君蓉 E-mail:[email protected]
更新日期/Last Update: 2020-08-20