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[1]申晟,尚延春,孟慶陽(yáng).自體與同種異體肌腱關(guān)節(jié)鏡下重建前交叉韌帶的對(duì)比研究[J].中醫(yī)正骨,2015,27(07):34-37.
　SHEN Sheng,SHANG Yanchun,MENG Qingyang.A retrospective trial of autologous tendon versus allogeneic tendon for arthroscopic anterior cruciate ligament reconstruction[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):34-37.
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自體與同種異體肌腱關(guān)節(jié)鏡下重建前交叉韌帶的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年07期
頁(yè)碼:
34-37
欄目:
臨床研究
出版日期:
2015-07-31

文章信息/Info

Title:
A retrospective trial of autologous tendon versus allogeneic tendon for arthroscopic anterior cruciate ligament reconstruction
作者:
申晟; 尚延春; 孟慶陽(yáng)
河南省洛陽(yáng)正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽(yáng) 471002
Author(s):
SHEN Sheng; SHANG Yanchun; MENG Qingyang
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
前交叉韌帶重建;  關(guān)節(jié)鏡檢查;  移植; 自體;  移植; 同種
Keywords:
anterior cruciate ligament reconstruction;  arthroscopy;  transplantation; autologous;  transplantation; homologous
摘要:
目的:比較自體與同種異體肌腱關(guān)節(jié)鏡下重建前交叉韌帶(anterior cruciate ligament,ACL)的臨床療效。方法:回顧性分析64例行關(guān)節(jié)鏡下重建ACL患者的病例資料,其中32例采用自體肌腱(自體肌腱組),其余32例采用同種異體肌腱(異體肌腱組)。比較2組患者的手術(shù)時(shí)間、術(shù)后發(fā)熱時(shí)間、住院時(shí)間、膝關(guān)節(jié)穩(wěn)定性、患膝國(guó)際膝關(guān)節(jié)文獻(xiàn)委員會(huì)(the international knee documentation committee,IKDC)評(píng)分及Lysholm評(píng)分,膝關(guān)節(jié)穩(wěn)定性采用Lachman試驗(yàn)、中立位前抽屜試驗(yàn)(anterior drawer test,ADT)評(píng)定。結(jié)果:2組患者術(shù)后均出現(xiàn)發(fā)熱,自體肌腱組術(shù)后發(fā)熱時(shí)間比異體肌腱組短[(2.0±1.5)d,(4.0±1.7)d,t=5.043,P=0.000],手術(shù)時(shí)間比異體肌腱組長(zhǎng)[(79±15)min,(60±13)min,t=5.405,P=0.000]; 2組住院時(shí)間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(14±3)d,(14±4)d,t=0.000,P=1.000]。術(shù)前及術(shù)后6個(gè)月時(shí)2組患者Lachman試驗(yàn)和中立位ADT試驗(yàn)陽(yáng)性率比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.000,P=1.000; χ2=0.000,P=1.000; χ2=0.087,P=0.768; χ2=0.000,P=1.000); 與術(shù)前相比,術(shù)后6個(gè)月時(shí)2組患者的Lachman試驗(yàn)和中立位ADT試驗(yàn)陽(yáng)性率均降低(χ2=42.416,P=0.000; χ2=42.250,P=0.000; χ2=34.724,P=0.000; χ2=37.312,P=0.000)。術(shù)前及術(shù)后6個(gè)月時(shí)2組患者的IKDC評(píng)分和Lysholm評(píng)分比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義[(41.52±3.47)分,(40.33±3.41)分,t=1.381,P=0.172;(82.01±1.50)分,(81.92±1.30)分,t=0.305,P=0.762;(39.82±3.23)分,(40.03±2.69)分,t=0.302,P=0.764;(89.56±1.86)分,(89.50±1.72)分,t=0.140,P=0.889]; 與術(shù)前相比,術(shù)后6個(gè)月時(shí)2組患者的IKDC評(píng)分和Lysholm評(píng)分均增加(t=61.218,P=0.000; t=70.920,P=0.000; t=63.114,P=0.000; t=94.223,P=0.000)。結(jié)論:與采用自體肌腱相比,采用同種異體肌腱重建ACL手術(shù)時(shí)間短,但存在免疫排斥反應(yīng),而二者的臨床療效相當(dāng)。
Abstract:
Objective:To compare the clinical curative effects of autologous tendon versus allogeneic tendon in arthroscopic anterior cruciate ligament(ACL)reconstruction.Methods:The medical records of 64 patients that were treated with arthroscopic ACL reconstruction were analyzed retrospectively.Thirty two patients(autologous tendon group)were treated with autologous tendon,while the others(allogeneic tendon group)were treated with allogeneic tendon.The operation time,postoperative duration of fever,hospital stay,knee joint stability,the international knee documentation committee(IKDC)scores and Lysholm scores were compared between the two groups.The knee joint stability were evaluated by Lachman test and anterior drawer test(ADT)in neutral position.Results:Patients had fever after the surgery in both of the two groups,and the postoperative duration of fever was shorter in autologous tendon group compared to allogeneic tendon group(2.0+/-1.5 vs 4.0+/-1.7 days,t=5.043,P=0.000),while the operation time was longer in autologous tendon group compared to allogeneic tendon group(79+/-15 vs 60+/-13 min,t=5.405,P=0.000).There was no statistical difference in the hospital stay between the 2 groups(14+/-3 vs 14+/-4 days,t=0.000,P=1.000).There was no statistical difference in positive rate of Lachman test and neutral position ADT between the 2 groups before the surgery and at 6 months after the surgery(χ2=0.000,P=1.000; χ2=0.000,P=1.000; χ2=0.087,P=0.768; χ2=0.000,P=1.000).The positive rate of Lachman test and neutral position ADT decreased in both of the 2 groups at 6 months after the surgery(χ2=42.416,P=0.000; χ2=42.250,P=0.000; χ2=34.724,P=0.000; χ2=37.312,P=0.000).There was no statistical difference in IKDC scores and Lysholm scores between the 2 groups before the surgery and at 6 months after the surgery(41.52+/-3.47 vs 40.33+/-3.41 points,t=1.381,P=0.172; 82.01+/-1.50 vs 81.92+/-1.30 points,t=0.305,P=0.762; 39.82+/-3.23 vs 40.03+/-2.69,t=0.302,P=0.764; 89.56+/-1.86 vs 89.50+/-1.72 points,t=0.140,P=0.889).The IKDC scores and Lysholm scores increased in both of the 2 groups at 6 months after the surgery(t=61.218,P=0.000; t=70.920,P=0.000; t=63.114,P=0.000; t=94.223,P=0.000).Conclusion:The allogeneic tendon ACL reconstruction has shorter operative time compared to autologous tendon ACL reconstruction,while they are similar to each other in clinical curative effects,but the former can incur immunological rejection.

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備注/Memo:
2014-12-05收稿 2015-05-25修回
更新日期/Last Update: 2015-07-30