[1]程松苗,胡勇,陈君蓉,等.Rigidfix横穿钉固定移植肌腱胫骨端重建前交叉韧带的临床研究[J].中医正骨,2020,32(08):12-16.
　CHENG Songmiao,HU Yong,CHEN Junrong,et al.A clinical study of fixation of tibial end of transplanted tendon with Rigidfix cross-pins in surgery of anterior cruciate ligament reconstruction[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(08):12-16.
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Rigidfix横穿钉固定移植肌腱胫骨端重建前交叉韧带的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年08期
页码:
12-16
栏目:
临床研究
出版日期:
2020-08-20

文章信息/Info

Title:
A clinical study of fixation of tibial end of transplanted tendon with Rigidfix cross-pins in surgery of anterior cruciate ligament reconstruction
作者:
程松苗; 胡勇; 陈君蓉; 陈鹏旭; 蒋旭; 李强; 孙敏
(四川省骨科医院,四川 成都 610041)
Author(s):
CHENG Songmiao; HU Yong; CHEN Junrong; CHEN Pengxu; JIANG Xu; LI Qiang; SUN Min
Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China
关键词:
前交叉韧带重建;  腱固定术;  Rigidfix横穿钉;  临床试验
Keywords:
anterior cruciate ligament reconstruction;  tenodesis;  Rigidfix cross pin;  clinical trial
摘要:
目的:探讨Rigidfix横穿钉固定移植肌腱胫骨端重建前交叉韧带的临床疗效和安全性。方法:回顾性分析99例采用自体腘绳肌肌腱重建前交叉韧带(anterior cruciate ligament,ACL)患者的病例资料,其中移植肌腱胫骨端采用Rigidfix横穿钉固定50例(横穿钉固定组)、采用Intrafix界面螺钉固定49例(界面螺钉固定组)。比较2组患者的手术时间、术后至完全负重行走时间、Lysholm评分、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)膝关节评分、胫骨隧道内口扩大值及并发症发生情况。结果:2组患者的手术时间、术后至完全负重行走时间比较,组间差异均无统计学意义[(55.3±5.3)min,(53.5±4.3)min,t=1.891,P=0.062;(19.0±5.1)d,(18.3±3.8)d,t=0.741,P=0.461]。所有患者均获得随访,随访时间24～35个月,中位数33个月。切口均甲级愈合。2组患者术后1年Lysholm评分、IKDC膝关节评分比较,组间差异均无统计学意义[(90.4±1.7)分,(90.9±1.7)分,t=-1.575,P=0.118;(86.0±3.2)分,(86.1±2.9)分,t=-0.069,P=0.945]。胫骨隧道内口扩大值,横穿钉固定组低于界面螺钉固定组[(1.49±0.11)mm,(2.52±0.17)mm,t=-36.488,P=0.000]。横穿钉固定组2例出现横穿钉穿出骨皮质,界面螺钉固定组25例出现螺钉偏移骨隧道,均未做处理,随访期间未见异常。均无膝关节僵硬、神经血管损伤、膝关节感染等并发症发生。横穿钉固定组的并发症发生率低于界面螺钉固定组(χ2=27.585,P=0.000)。结论:采用自体肌腱重建ACL时,移植肌腱胫骨端采用Rigidfix横穿钉固定和Intrafix界面螺钉固定的短期临床疗效相当,但Rigidfix横穿钉固定安全性更高。
Abstract:
To explore the clinical curative effects and the safety of fixation of tibial end of transplanted tendon with Rigidfix cross-pins in surgery of anterior cruciate ligament reconstruction(ACLR).Methods:The medical records of 99 patients who received ACLR with autologous hamstring tendon were analyzed retrospectively.The tibial end of transplanted tendon was fixed with Rigidfix cross-pins in 50 patients(cross-pin fixation group)and Intrafix interference screw in 49 patients(interference screw fixation group)respectively.The operative time,postoperative full weight-bearing walking start time,Lysholm scores,International Knee Documentation Committee(IKDC)knee scores,enlarged value of tibial tunnel entrance and complication incidences were compared between the 2 groups.Results:There was no statistical difference in operative time and postoperative full weight-bearing walking start time between the 2 groups(55.3+/-5.3 vs 53.5+/-4.3 min,t=1.891,P=0.062; 19.0+/-5.1 vs 18.3+/-3.8 days,t=0.741,P=0.461).All patients in the 2 groups got primary healing in the surgical incisions and all patients in the 2 groups were followed up for 24-35 months with a median of 33 months.There was no statistical difference in Lysholm scores and IKDC knee scores between the 2 groups at 1 year after the surgery(90.4+/-1.7 vs 90.9+/-1.7 points,t=-1.575,P=0.118; 86.0+/-3.2 vs 86.1+/-2.9 points,t=-0.069,P=0.945).The enlarged values of tibial tunnel entrance were lower in cross-pin fixation group compared to interference screw fixation group(1.49+/-0.11 vs 2.52+/-0.17 mm,t=-36.488,P=0.000).The cross-pin punched out of the bone cortex in 2 patients in cross-pin fixation group,and the screw deviated from tibial tunnel in 25 patients in interference screw fixation group.No special treatment was performed and no abnormalities were found during the follow-up period.No complications such as knee joint stiffness,neurovascular injury and knee arthrosis infection were found in the 2 groups.The incidence rate of complications was lower in cross-pin fixation group compared to interference screw

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备注/Memo

备注/Memo:
基金项目:四川省卫生和计划生育委员会科研课题(16PJ388) 通讯作者:陈君蓉 E-mail:475470567@qq.com
更新日期/Last Update: 2020-08-20