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关节镜下经胫骨单束后交叉韧带重建中自体腘绳肌腱移植与异体胫前肌腱移植的比较

Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction.

作者信息

Li Bin, Wang Jia-Shi, He Ming, Wang Guang-Bin, Shen Peng, Bai Lun-Hao

机构信息

Department of Joint Surgery and Sports Medicine, Shengjing Hospital, China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, 110022, China.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Oct;23(10):3077-84. doi: 10.1007/s00167-014-3267-z. Epub 2014 Sep 6.

Abstract

PURPOSE

To compare the outcomes between hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament (PCL) reconstruction.

METHODS

Thirty-seven patients undergoing isolated single-bundle PCL reconstruction were enrolled in this study, and their data were retrospectively analyzed. They were divided into group A [4-strand hamstring tendon autograft (4SHG), n = 18] and group B [2-strand tibialis anterior allograft (2STAG), n = 19] and followed up for 2 years at least. Several parameters including the International Knee Documentation Committee score, Lysholm knee score, Tegner activity rating and knee laxity arthrometer were evaluated, and physical examination was performed preoperatively and postoperatively, and postoperative complications were also observed in all patients. Meanwhile, the postoperative posterior instability was compared between the affected knee and the contra-lateral knee.

RESULTS

Compared with preoperative knee laxity and function, both groups had significant improvement postoperatively (P < 0.01). However, there were no significant differences in knee laxity and function between both groups (n.s.). Compared with contra-lateral knee, the posterior stability was worse in the affected knee (P < 0.01).

CONCLUSIONS

The outcomes were similar between 4SHG or 2STAG in PCL reconstruction. Compared with contra-lateral knees, the affected knees have slight residual knee laxity in both groups.

LEVEL OF EVIDENCE

Retrospective comparative study, Level III.

摘要

目的

比较关节镜下经胫骨单束后交叉韧带(PCL)重建中腘绳肌腱自体移植与胫骨前肌异体移植的效果。

方法

本研究纳入37例行单纯单束PCL重建的患者,并对其数据进行回顾性分析。将他们分为A组[4股腘绳肌腱自体移植(4SHG),n = 18]和B组[2股胫骨前肌异体移植(2STAG),n = 19],并至少随访2年。评估了包括国际膝关节文献委员会评分、Lysholm膝关节评分、Tegner活动评级和膝关节松弛度测量仪等多个参数,在术前和术后进行了体格检查,并且观察了所有患者的术后并发症。同时,比较了患侧膝关节与对侧膝关节术后的后向不稳定情况。

结果

与术前膝关节松弛度和功能相比,两组术后均有显著改善(P < 0.01)。然而,两组之间的膝关节松弛度和功能无显著差异(无统计学意义)。与对侧膝关节相比,患侧膝关节的后向稳定性更差(P < 0.01)。

结论

PCL重建中4SHG或2STAG的效果相似。与对侧膝关节相比,两组患侧膝关节均有轻微的残余膝关节松弛度。

证据水平

回顾性比较研究,III级。

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