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自体移植与同种异体移植重建前交叉韧带撕裂的临床结果比较。

Comparison of Clinical Outcome of Autograft and Allograft Reconstruction for Anterior Cruciate Ligament Tears.

作者信息

Jia Yu-Hua, Sun Peng-Fei

机构信息

Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.

出版信息

Chin Med J (Engl). 2015 Dec 5;128(23):3163-6. doi: 10.4103/0366-6999.170265.

Abstract

BACKGROUND

Hamstring (HS) autograft and bone-patellar tendon-bone allograft are the most common choice for reconstruction of anterior cruciate ligament (ACL). There was a little report about the clinical outcome and difference of arthroscopic ACL reconstruction using allograft and autograft. This study aimed to compare the clinical outcome of autograft and allograft reconstruction for ACL tears.

METHODS

A total of 106 patients who underwent surgery because of ACL tear were included in this study. The patients were randomly divided into two groups, including 53 patients in each group. The patients in group I underwent standard ACL reconstruction with HS tendon autografts, while others in group II underwent reconstruction with bone-patellar tendon-bone allograft. All the patients were followed up and analyzed; the mean follow-up was 81 months (range: 28-86 months). Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm scores, physical instability tests, and patient satisfaction questionnaires. The complication rates of both groups were compared. Tibial and femoral tunnel widening were assessed using lateral and anteroposterior radiographs.

RESULTS

At the end of follow-up, no significant differences were found between the groups in terms of IKDC, Lysholm scores, physical instability tests, patient satisfaction questionnaires, and incidences of arthrofibrosis. Tibial and femoral tunnel widening was less in the HS tendon autografts. This difference was more significant on the tibial side.

CONCLUSIONS

In the repair of ACL tears, allograft reconstruction is as effective as the autograft reconstruction, but the allograft can lead to more tunnel widening evidently in the tibial tunnel, particularly.

摘要

背景

腘绳肌(HS)自体移植和骨-髌腱-骨同种异体移植是前交叉韧带(ACL)重建最常用的选择。关于同种异体移植和自体移植进行关节镜下ACL重建的临床结果及差异的报道较少。本研究旨在比较ACL撕裂自体移植和同种异体移植重建的临床结果。

方法

本研究纳入了106例因ACL撕裂接受手术的患者。患者被随机分为两组,每组53例。第一组患者采用HS肌腱自体移植进行标准ACL重建,而第二组其他患者采用骨-髌腱-骨同种异体移植进行重建。对所有患者进行随访和分析;平均随访时间为81个月(范围:28 - 86个月)。使用国际膝关节文献委员会(IKDC)、Lysholm评分、身体不稳定测试和患者满意度问卷评估临床结果。比较两组的并发症发生率。使用正侧位X线片评估胫骨和股骨隧道增宽情况。

结果

随访结束时,两组在IKDC、Lysholm评分、身体不稳定测试、患者满意度问卷及关节纤维化发生率方面均未发现显著差异。HS肌腱自体移植组的胫骨和股骨隧道增宽较少。这种差异在胫骨侧更为显著。

结论

在ACL撕裂修复中,同种异体移植重建与自体移植重建同样有效,但同种异体移植尤其会导致胫骨隧道明显更宽。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2125/4794891/1440d1d6175b/CMJ-128-3163-g001.jpg

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