[1]申晟,尚延春,孟庆阳.自体与同种异体肌腱关节镜下重建前交叉韧带的对比研究[J].中医正骨,2015,27(07):34-37.
　SHEN Sheng,SHANG Yanchun,MENG Qingyang.A retrospective trial of autologous tendon versus allogeneic tendon for arthroscopic anterior cruciate ligament reconstruction[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):34-37.
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自体与同种异体肌腱关节镜下重建前交叉韧带的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年07期
页码:
34-37
栏目:
临床研究
出版日期:
2015-07-31

文章信息/Info

Title:
A retrospective trial of autologous tendon versus allogeneic tendon for arthroscopic anterior cruciate ligament reconstruction
作者:
申晟; 尚延春; 孟庆阳
河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002
Author(s):
SHEN Sheng; SHANG Yanchun; MENG Qingyang
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
关键词:
前交叉韧带重建;  关节镜检查;  移植; 自体;  移植; 同种
Keywords:
anterior cruciate ligament reconstruction;  arthroscopy;  transplantation; autologous;  transplantation; homologous
摘要:
目的:比较自体与同种异体肌腱关节镜下重建前交叉韧带(anterior cruciate ligament,ACL)的临床疗效。方法:回顾性分析64例行关节镜下重建ACL患者的病例资料,其中32例采用自体肌腱(自体肌腱组),其余32例采用同种异体肌腱(异体肌腱组)。比较2组患者的手术时间、术后发热时间、住院时间、膝关节稳定性、患膝国际膝关节文献委员会(the international knee documentation committee,IKDC)评分及Lysholm评分,膝关节稳定性采用Lachman试验、中立位前抽屉试验(anterior drawer test,ADT)评定。结果:2组患者术后均出现发热,自体肌腱组术后发热时间比异体肌腱组短[(2.0±1.5)d,(4.0±1.7)d,t=5.043,P=0.000],手术时间比异体肌腱组长[(79±15)min,(60±13)min,t=5.405,P=0.000]; 2组住院时间比较,差异无统计学意义[(14±3)d,(14±4)d,t=0.000,P=1.000]。术前及术后6个月时2组患者Lachman试验和中立位ADT试验阳性率比较,组间差异均无统计学意义(χ2=0.000,P=1.000; χ2=0.000,P=1.000; χ2=0.087,P=0.768; χ2=0.000,P=1.000); 与术前相比,术后6个月时2组患者的Lachman试验和中立位ADT试验阳性率均降低(χ2=42.416,P=0.000; χ2=42.250,P=0.000; χ2=34.724,P=0.000; χ2=37.312,P=0.000)。术前及术后6个月时2组患者的IKDC评分和Lysholm评分比较,组间差异均无统计学意义[(41.52±3.47)分,(40.33±3.41)分,t=1.381,P=0.172;(82.01±1.50)分,(81.92±1.30)分,t=0.305,P=0.762;(39.82±3.23)分,(40.03±2.69)分,t=0.302,P=0.764;(89.56±1.86)分,(89.50±1.72)分,t=0.140,P=0.889]; 与术前相比,术后6个月时2组患者的IKDC评分和Lysholm评分均增加(t=61.218,P=0.000; t=70.920,P=0.000; t=63.114,P=0.000; t=94.223,P=0.000)。结论:与采用自体肌腱相比,采用同种异体肌腱重建ACL手术时间短,但存在免疫排斥反应,而二者的临床疗效相当。
Abstract:
Objective:To compare the clinical curative effects of autologous tendon versus allogeneic tendon in arthroscopic anterior cruciate ligament(ACL)reconstruction.Methods:The medical records of 64 patients that were treated with arthroscopic ACL reconstruction were analyzed retrospectively.Thirty two patients(autologous tendon group)were treated with autologous tendon,while the others(allogeneic tendon group)were treated with allogeneic tendon.The operation time,postoperative duration of fever,hospital stay,knee joint stability,the international knee documentation committee(IKDC)scores and Lysholm scores were compared between the two groups.The knee joint stability were evaluated by Lachman test and anterior drawer test(ADT)in neutral position.Results:Patients had fever after the surgery in both of the two groups,and the postoperative duration of fever was shorter in autologous tendon group compared to allogeneic tendon group(2.0+/-1.5 vs 4.0+/-1.7 days,t=5.043,P=0.000),while the operation time was longer in autologous tendon group compared to allogeneic tendon group(79+/-15 vs 60+/-13 min,t=5.405,P=0.000).There was no statistical difference in the hospital stay between the 2 groups(14+/-3 vs 14+/-4 days,t=0.000,P=1.000).There was no statistical difference in positive rate of Lachman test and neutral position ADT between the 2 groups before the surgery and at 6 months after the surgery(χ2=0.000,P=1.000; χ2=0.000,P=1.000; χ2=0.087,P=0.768; χ2=0.000,P=1.000).The positive rate of Lachman test and neutral position ADT decreased in both of the 2 groups at 6 months after the surgery(χ2=42.416,P=0.000; χ2=42.250,P=0.000; χ2=34.724,P=0.000; χ2=37.312,P=0.000).There was no statistical difference in IKDC scores and Lysholm scores between the 2 groups before the surgery and at 6 months after the surgery(41.52+/-3.47 vs 40.33+/-3.41 points,t=1.381,P=0.172; 82.01+/-1.50 vs 81.92+/-1.30 points,t=0.305,P=0.762; 39.82+/-3.23 vs 40.03+/-2.69,t=0.302,P=0.764; 89.56+/-1.86 vs 89.50+/-1.72 points,t=0.140,P=0.889).The IKDC scores and Lysholm scores increased in both of the 2 groups at 6 months after the surgery(t=61.218,P=0.000; t=70.920,P=0.000; t=63.114,P=0.000; t=94.223,P=0.000).Conclusion:The allogeneic tendon ACL reconstruction has shorter operative time compared to autologous tendon ACL reconstruction,while they are similar to each other in clinical curative effects,but the former can incur immunological rejection.

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备注/Memo

备注/Memo:
2014-12-05收稿 2015-05-25修回
更新日期/Last Update: 2015-07-30