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同种异体韧带移植治疗前交叉韧带重建合并半月板撕裂患者。

Allograft ligament transplantation in anterior cruciate ligament reconstruction patients with meniscal tears.

机构信息

Orthopaedics Department, Nanshan Hospital of Guangdong Medical College, NO. 89, Taoyuan Road, Shenzhen, Peoples' Republic of China,

出版信息

Arch Orthop Trauma Surg. 2014 Apr;134(4):521-7. doi: 10.1007/s00402-014-1929-4. Epub 2014 Jan 30.

Abstract

BACKGROUND

It currently remains unclear whether the meniscal repair clinical results were affected by the graft used in anterior cruciate ligament (ACL) reconstruction. This retrospective study designed to evaluate the difference in clinical outcomes of meniscal repair using autograft and allograft for the ACL reconstruction.

METHODS

The injury of the ACL and meniscus was evaluated with MRI and treated simultaneously. One hundred and eighty-nine cases were initially fulfilled the study criteria, and had the surgery in the period June 2007 and July 2010. Thirty-four patients were lost to follow-up. Seventy-five patients underwent meniscus repair with autograft reconstruction of the ACL (autograft group) and 80 patients underwent meniscus repair with allograft reconstruction of the ACL (allograft group).

RESULTS

The meniscus healing rate based on the clinical examination of Barrett's criteria was 81.3 % (61/75) in the autograft group and 80.0 % (64/80) in the allograft (P > 0.05). There was no significant difference in the Lysholm scores in the allograft group compared to the allograft group (89.1 ± 10.6 versus 88.7 ± 11.2, P > 0.05). The values of immunoglobulin's and complements (IgG, IgA, IgM, C3 and C4) were not significantly different between the two groups (P > 0.05).

CONCLUSION

The data support our assumption that patients undergoing meniscal repair associated with ACL reconstruction with allograft had good clinical outcomes. Although allograft implantation induces an immunological response on a subclinical level, there were no signs of allograft affecting the nature of meniscus healing.

摘要

背景

目前尚不清楚前交叉韧带(ACL)重建中使用的移植物是否会影响半月板修复的临床结果。本回顾性研究旨在评估 ACL 重建中使用自体移植物和同种异体移植物进行半月板修复的临床结果差异。

方法

ACL 和半月板的损伤通过 MRI 进行评估,并同时进行治疗。最初有 189 例符合研究标准的病例,在 2007 年 6 月至 2010 年 7 月期间接受了手术。34 例患者失访。75 例患者接受 ACL 自体移植物重建半月板修复(自体移植物组),80 例患者接受 ACL 同种异体移植物重建半月板修复(同种异体移植物组)。

结果

根据 Barrett 标准的临床检查,自体移植物组半月板愈合率为 81.3%(61/75),同种异体移植物组为 80.0%(64/80)(P>0.05)。同种异体移植物组的 Lysholm 评分与同种异体移植物组相比无显著差异(89.1±10.6 与 88.7±11.2,P>0.05)。两组免疫球蛋白和补体(IgG、IgA、IgM、C3 和 C4)的数值无显著差异(P>0.05)。

结论

数据支持我们的假设,即接受 ACL 重建联合同种异体移植物半月板修复的患者具有良好的临床结果。虽然同种异体移植物植入会在亚临床水平引起免疫反应,但没有迹象表明同种异体移植物会影响半月板愈合的性质。

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