自体单肌腱加与不加高强度编织重建后交叉韧带的临床比较研究

Lei Zhang
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The posterior drawer test (PDT) was used as the knee joint stability test to evaluate the knee function, IKDC score, Lysholm score and Tegner score were used as the evaluation criteria.The evaluation results of the knee joint in the experimental group and the control group were compared before and one year after the operation, and the evaluation results of the knee joint in the two groups were compared one year after the operation and one year before the operation Results Functional aspects of knee joint: The Lysholm score of the experimental group was expressed by median (quartile) 1 year before and after operation.Lysholm scores of the trail group were 64 (40, 81) and 84 (73, 87) preoperative and postoperative, respectively, the control group were 68 (48, 78) and 80 (70, 90) respectively, there was statistically difference before and after surgery (Z value was -2.535 and -3.576, P value was 0.011 and 0.05). The Tegner score of the experimental group before and 1 year after operation was expressed as the median [quartile], which was 2.0 (1.0, 2.5), 6.0 (5.0, 7.5) respectively, and that of the control group was 2.0 (1.0, 3.0), 6.0 (4.0, 7.0) respectively.There was statistically significant difference between the two groups before and after operation (Z value was -3.397, -4.122, all P 0.05). One year after operation, the IKDC scores of the two groups were significantly improved (Z values were -3.750, -4.234, all P 0.05). There was no significant difference between the two groups in the postoperative drawer test (P>0.05); one year after the operation, the stability of the two groups was significantly improved (Z values were -3.674, -4.083, all P<0.01), and the stability of the experimental group was significantly better than that of the control group(Z=0.156, P=0.039). 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引用次数: 0

摘要

目的观察关节镜下自体单肌腱重建后交叉韧带时使用高强度编织线与不使用编织线的临床效果差异。方法回顾性分析2017 ~ 2018年中国医科大学附属盛京医院收治的40例后交叉韧带断裂及韧带重建患者的临床资料。根据自体腘绳肌移植物中是否添加Arthrex ar-7200 (Arthrex, Naples, FL, USA)编织缝线,将患者分为试验组(17例)和对照组(23例)。采用后抽屉试验(PDT)作为膝关节稳定性试验评价膝关节功能,以IKDC评分、Lysholm评分和Tegner评分作为评价标准。比较实验组和对照组患者术前和术后1年的膝关节评价结果,比较两组患者术后1年和术后1年的膝关节评价结果。结果膝关节功能方面:实验组患者术前和术后1年Lysholm评分用中位数(四分位数)表示。试验组术前、术后Lysholm评分分别为64分(40、81分)、84分(73、87分),对照组术前、术后Lysholm评分分别为68分(48、78分)、80分(70、90分),两组术前、术后比较差异有统计学意义(Z值分别为-2.535、-3.576,P值分别为0.011、0.05)。实验组术前和术后1年Tegner评分用中位数[四分位数]表示,分别为2.0(1.0、2.5)、6.0(5.0、7.5),对照组分别为2.0(1.0、3.0)、6.0(4.0、7.0)。两组术前、术后比较差异有统计学意义(Z值分别为-3.397、-4.122,P值均为0.05)。术后1年,两组患者IKDC评分均有显著改善(Z值分别为-3.750、-4.234,P均为0.05)。两组术后抽屉试验比较,差异无统计学意义(P < 0.05);术后1年,两组的稳定性均显著提高(Z值分别为-3.674、-4.083,P均<0.01),且实验组的稳定性显著优于对照组(Z=0.156, P=0.039)。结论自体腘绳肌重建后交叉韧带可获得满意的临床效果,且在移植物中置入高强度编织缝合线更有利于恢复膝关节的稳定性。关键词:后交叉韧带;韧带重建;关节镜;自体肌腱
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A clinical comparative study on the reconstruction of posterior cruciate ligament with single tendon autograft plus high-strength braid or not
Objective To observe the difference of the clinical effect of using high-strength woven suture or not in the reconstruction of posterior cruciate ligament (PCL) with single tendon autograft under arthroscope. Methods The clinical data of 40 patients with posterior cruciate ligament rupture and ligament reconstruction admitted to Shengjing Hospital Affiliated to China Medical University from 2017 to 2018 were analyzed retrospectively.According to whether or not to add Arthrex ar-7200 (Arthrex, Naples, FL, USA) braided suture in the autogenous hamstring graft, the patients were divided into test group (17 cases) and control group (23 cases). The posterior drawer test (PDT) was used as the knee joint stability test to evaluate the knee function, IKDC score, Lysholm score and Tegner score were used as the evaluation criteria.The evaluation results of the knee joint in the experimental group and the control group were compared before and one year after the operation, and the evaluation results of the knee joint in the two groups were compared one year after the operation and one year before the operation Results Functional aspects of knee joint: The Lysholm score of the experimental group was expressed by median (quartile) 1 year before and after operation.Lysholm scores of the trail group were 64 (40, 81) and 84 (73, 87) preoperative and postoperative, respectively, the control group were 68 (48, 78) and 80 (70, 90) respectively, there was statistically difference before and after surgery (Z value was -2.535 and -3.576, P value was 0.011 and 0.05). The Tegner score of the experimental group before and 1 year after operation was expressed as the median [quartile], which was 2.0 (1.0, 2.5), 6.0 (5.0, 7.5) respectively, and that of the control group was 2.0 (1.0, 3.0), 6.0 (4.0, 7.0) respectively.There was statistically significant difference between the two groups before and after operation (Z value was -3.397, -4.122, all P 0.05). One year after operation, the IKDC scores of the two groups were significantly improved (Z values were -3.750, -4.234, all P 0.05). There was no significant difference between the two groups in the postoperative drawer test (P>0.05); one year after the operation, the stability of the two groups was significantly improved (Z values were -3.674, -4.083, all P<0.01), and the stability of the experimental group was significantly better than that of the control group(Z=0.156, P=0.039). Conclusion Posterior cruciate ligament reconstruction with autologous hamstring muscle can achieve satisfactory clinical results, and placing high-strength braided sutures in the graft is more conducive to the recovery of knee joint stability. Key words: Posterior cruciate ligament; Ligament reconstruction; Arthroscopy; Autogenous hamstring tendon
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来源期刊
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期刊介绍: Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.
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