Wang Zhihui, Chen Baicheng, Zhang Xiaoyang, Sun Ran, Liu Hu, Xie Lei, Zhu Chaohua
Department of Joint Surgery, Hospital of Hebei Medical University, Shijiazhuang Hebei 050051, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Oct;25(10):1256-60.
To study the effectiveness of anterior cruciate ligament (ACL) reconstruction using autologous periosteum wrapping tendon allograft by comparing with using simple tendon allograft.
Between March 2008 and November 2008, 68 patients with ACL injury were treated, who were in accordance with the inclusion criteria. They were divided into 2 groups randomly according to different treatment methods: ACL was reconstructed with autologous periosteum wrapping tendon allograft in 31 patients (test group) and with simple tendon allograft (control group) in 37 patients. There was no significant difference in gender, age, disease duration, the cause of injury, and functional score preoperatively between 2 groups (P > 0.05). Anatomic single-bundle ACL reconstruction was performed in 2 groups.
Little exudation at tibial tunnel incision was found in 1 case respectively in both groups at 2 weeks after operation and was cured by dressing change and antibiotics. The other incisions healed by first intention. The patients were followed up 24-29 months (mean, 26 months) in the test group and 24-32 months (mean, 27 months) in the control group. CT showed bone tunnel enlargement in both groups at 2 years after operation, but the rate of the tunnel enlargement was less in the test group (5/31, 16.1%) than in the control group (14/37, 37.8%), showing significant difference (chi2 = 3.948, P = 0.047). At 2 years after operation, the results of Lachman test and pivot shift test were negative in 23 cases (74.2%) and 25 cases (80.6%) of the test group, and in 26 cases (70.3%) and 30 cases (81.1%) of the control group, respectively. KT-1000 examination showed the displacement of the test group [(1.74 +/- 0.88) mm] was less than that of the control group [(2.36 +/- 0.83) mm], showing significant difference (t = -2.979, P = 0.004). There was no significant difference in Lysholm score, Hospital for Special Surgery (HSS) score, Tegner score, and International Knee Documentation Committee (IKDC) score between 2 groups at 2 years after operation (P > 0.05).
Compared with simple tendon allograft, ACL reconstruction with autologous periosteum wrapping tendon allograft can improve tendon-bone healing, and decrease the rate of bone tunnel enlargement, so it has good short-term outcome.
通过与单纯同种异体肌腱移植对比，研究采用自体骨膜包裹同种异体肌腱进行前交叉韧带（ACL）重建的有效性。
2008年3月至2008年11月，治疗68例符合纳入标准的ACL损伤患者。根据不同治疗方法将其随机分为2组：31例患者采用自体骨膜包裹同种异体肌腱重建ACL（试验组），37例患者采用单纯同种异体肌腱重建（对照组）。两组患者在性别、年龄、病程、损伤原因及术前功能评分方面差异无统计学意义（P>0.05）。两组均行解剖单束ACL重建。
术后2周，两组各有1例患者胫骨隧道切口有少量渗出，经换药及应用抗生素后治愈。其余切口均一期愈合。试验组患者随访24 - 29个月（平均26个月），对照组患者随访24 - 32个月（平均27个月）。术后2年CT显示两组均有骨隧道扩大，但试验组骨隧道扩大率（5/31，16.1%）低于对照组（14/37，37.8%），差异有统计学意义（χ2 = 3.948，P = 0.047）。术后2年，试验组Lachman试验和轴移试验结果阴性分别为23例（74.2%）和25例（80.6%），对照组分别为26例（70.3%）和30例（81.1%）。KT - 1000检查显示试验组移位[（1.74±0.88）mm]小于对照组[（2.36±0.8३）mm]，差异有统计学意义（t = - 2.979，P = 0.004）。术后2年两组Lysholm评分、特种外科医院（HSS）评分、Tegner评分及国际膝关节文献委员会（IKDC）评分差异无统计学意义（P>0.05）。
与单纯同种异体肌腱移植相比，自体骨膜包裹同种异体肌腱重建ACL可促进腱骨愈合，降低骨隧道扩大率，短期疗效良好。
