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前交叉韧带重建中的移植物选择——髌腱自体移植物与同种异体移植物的前瞻性分析

Graft selection in anterior cruciate ligament reconstruction--prospective analysis of patellar tendon autografts compared with allografts.

作者信息

Victor J, Bellemans J, Witvrouw E, Govaers K, Fabry G

机构信息

General Hospital St-Lucas, Brugge, Belgium.

出版信息

Int Orthop. 1997;21(2):93-7. doi: 10.1007/s002640050127.

Abstract

A prospective study of 73 arthroscopic anterior cruciate ligament reconstructions using either a patellar tendon autograft or an allograft was made to assess any difference in clinical outcome. Allocation was by availability of an allograft. There were 48 autografts and 25 allografts. Evaluation was by clinical examination and physical tests. At follow-up 2 years after operation, there were no statistically significant differences between the two groups in mobility or in physical tests, but KT-1000 evaluation showed a slightly greater anterior translation in the autografts at 6 months and one year, although at 2 years the allografts developed greater anterior laxity. Cybex testing showed greater quadriceps strength at 6 months and one year in the allografts, but at 2 years the strength was greater in the autografts. Re-rupture occurred in 3 allografts. ACL reconstruction with a patellar tendon allograft does not produce a significant functional deficit. Full quadriceps recovery takes 2 years. Allografts are not recommended as stability deteriorates with time.

摘要

对73例采用髌腱自体移植或同种异体移植进行关节镜下前交叉韧带重建的病例进行了前瞻性研究,以评估临床结果的差异。根据同种异体移植物的可获得性进行分配。其中有48例自体移植和25例同种异体移植。通过临床检查和体格测试进行评估。术后2年随访时,两组在活动度或体格测试方面无统计学显著差异,但KT - 1000评估显示,自体移植组在6个月和1年时前向平移略大,不过在2年时同种异体移植组出现了更大的前向松弛。Cybex测试显示,同种异体移植组在6个月和1年时股四头肌力量更大,但在2年时自体移植组力量更大。3例同种异体移植发生再断裂。使用髌腱同种异体移植进行前交叉韧带重建不会产生明显的功能缺陷。股四头肌完全恢复需要2年时间。不建议使用同种异体移植,因为随着时间推移稳定性会恶化。

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