自体腘绳肌腱与股四头肌腱前交叉韧带重建比较
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滕州市中心人民医院

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Comparison of anterior cruciate ligament reconstruction with autologous hamstring tendon and quadriceps tendon
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1.Tengzhou Central People'2.'3.s Hospital

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    摘要:

    [目的] 比较自体腘绳肌腱(hamstring tendon,HT)与股四头肌肌腱(quadriceps tendon,QT)重建前交叉韧带(anterior cruciate ligament,ACL)疗效。[方法] 回顾分析2016年11月-2019年l0月我院收治的86例患者临床资料,根据术前沟通移植物选择分为HT组与QT组各43例,分别行关节镜下自体HT、QT重建ACL术,比较两组围手术期、随访与影像结果。[结果] 两组患者均顺利完成手术,围手术期资料差异无统计学意义(P>0.05)。随访方面:HT组完全负重活动时间早于QT组(P<0.05)。两组患者Lysholm评分、IKDC2000评分、KT-1000侧侧差值逐渐改善(P<0.05)。术后两组Lysholm评分、IKDC2000评分差异无统计学意义(P>0.05)。术后3月两组KT-1000侧侧差值差异无统计学意义(P>0.05),术后6、12、24月QT组均小于HT组(P<0.05)。影像方面:两组股骨隧道逐步扩大(P<0.05),胫骨隧道扩大、Kellgren-Lawrence分级差异无统计学意义(P>0.05)。术后3、6、12月两组股骨隧道扩大差异无统计学意义(P>0.05),术后24月QT组股骨隧道扩大小于HT组(P<0.05)。两组胫骨隧道扩大、Kellgren-Lawrence分级差异均无统计学意义(P>0.05)。[结论] 与HT重建ACL相比,QT在术后膝关节前向松弛、股骨隧道扩大优于HT,完全负重活动时间晚于HT。

    Abstract:

    [Objective] To compare of anterior cruciate ligament (ACL) reconstruction by autologous hamstring tendon (HT) with quadriceps tendon (QT).[Methods] Retrospective analysis of the clinical data of 86 patients admitted to our hospital from November 2016 to October 2019,according to the preoperative communication graft selection, they were divided into HT group and HT group, with 43 cases in each group.They underwent arthroscopic reconstruction of ACL with autologous HT and QT,and compared the perioperative period, follow-up and imaging results of the two groups.[Results] The two groups of patients successfully completed the surgery,and the difference in perioperative data was not statistically significant(P>0.05).Follow-up,Time to full weight-bearing activity was earlier in the HT group than in the QT group(P<0.05).The Lysholm score, IKDC2000 score, and test results of KT-1000 improved gradually in both groups(P<0.05).The difference in Lysholm scores and IKDC2000 scores between the two groups after surgery were not statistically significant(P>0.05).There was no statistically significant difference in the test results of KT-1000 between the two groups at 3 months after surgery(P>0.05),and the QT group was smaller than the HT group at 6, 12 and 24 months after surgery(P<0.05).Radiographically,the femoral tunnel were gradually enlarged in both groups(P<0.05),and the difference in tibial tunnel enlargement、Kellgren-Lawrence grade were not statistically significant(P>0.05).The difference in femoral tunnel enlargement between the two groups at 3, 6 and 12 months after surgery was no statistically significant(P>0.05), and femoral tunnel enlargement in the QT group was smaller than that in the HT group at 24 months after surgery(P<0.05).The differences in tibial tunnel enlargement and Kellgren-Lawrence grade between the two groups were not statistically significant(P>0.05).[Conclusion] Compared with HT for ACL reconstruction,QT was superior to HT in terms of postoperative anterior relaxation of knee joint and expansion of femoral tunnel,but the time of complete weight-bearing activity is later than HT.

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  • 收稿日期:2022-12-07
  • 最后修改日期:2023-01-25
  • 录用日期:2023-03-21
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