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[前交叉韧带重建中骨-髌腱-骨移植:同种异体移植物与自体移植物的比较]

[Bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction: allograft versus autograft].

作者信息

Yang Liu, Guo Lin, Dai Can, Han Xue-song, Chen Guang-xing, Duan Xiao-jun, Dai Gang, Xie Feng

机构信息

Center for Joint Surgery, Southwest Hospital of the Third Military Medical University, Chongqing 400038, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Jan 15;45(2):82-5.

Abstract

OBJECTIVE

To evaluate the clinical result of arthroscopic anterior cruciate ligament (ACL) reconstruction with either allo- or auto- bone-patellar tendon-bone (B-PT-B) grafts.

METHODS

From February 2002 to January 2006, 142 of 187 cases of ACL ruptures who received ACL reconstruction with B-PT-B grafts were studied retrospectively. There were 93 male and 49 female whose age was from 15 to 57 years (mean 26 years). Patients were divided into 2 groups by graft selection: 38 patients with autograft and 104 with allograft. Clinical results were evaluated according to IKDC, Lysholm, Irgang and Larson scales. Sub-items of scales such as pain, swelling and laxity were specifically evaluated.

RESULTS

All of the patients were followed up with an average of 24 months (range from 6 to 43 months). All grafts were radiographically in good position at the time of follow-up. KT-1000 examination of affected knee showed less than 3 mm anterior translation difference compared with contralateral one's. Allograft group: 85 patients got normal IKDC score (81.7%). Lysholm score 82.8 +/- 8.5, Irgang score 79.2 +/- 7.3, Larson score 86.7 +/- 3.1. Autograft group: 29 patients got normal IKDC score (76.3%). Lysholm score 84.6 +/- 9.5, Irgang score 79.5 +/- 7.6, Larson score 88.9 +/- 6.8. No significant statistical difference was found between the 2 groups in the comprehend scale (P>0.05).

CONCLUSIONS

Both autograft and allograft group achieve good results, and the allograft B-PT-B could provide the similar clinical result as autograft, the preliminary result of allograft reconstruction might indicate predictable result in the future.

摘要

目的

评估同种异体或自体骨-髌腱-骨(B-PT-B)移植物行关节镜下前交叉韧带(ACL)重建的临床效果。

方法

回顾性研究2002年2月至2006年1月期间187例接受B-PT-B移植物ACL重建的ACL断裂患者中的142例。其中男性93例,女性49例,年龄15至57岁(平均26岁)。根据移植物选择将患者分为2组:38例自体移植物患者和104例同种异体移植物患者。根据IKDC、Lysholm、Irgang和Larson量表评估临床效果。对量表的疼痛、肿胀和松弛等子项目进行了具体评估。

结果

所有患者均获随访,平均随访24个月(6至43个月)。随访时所有移植物在影像学上位置良好。患侧膝关节KT-1000检查显示与对侧相比前向移位差异小于3mm。同种异体移植物组:85例患者IKDC评分正常(81.7%)。Lysholm评分82.8±8.5,Irgang评分79.2±7.3,Larson评分86.7±3.1。自体移植物组:29例患者IKDC评分正常(76.3%)。Lysholm评分84.6±9.5,Irgang评分79.5±7.6,Larson评分88.9±6.8。两组在综合量表上无显著统计学差异(P>0.05)。

结论

自体移植物组和同种异体移植物组均取得良好效果,同种异体B-PT-B移植物可提供与自体移植物相似的临床效果,同种异体移植物重建的初步结果可能预示着未来可预测的结果。

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