[Effectiveness comparison of LARS artificial ligament and autogenous hamstring tendon in one-stage reconstruction of anterior and posterior cruciate ligaments].

医学 外科 前交叉韧带 后交叉韧带 肌腱 韧带 腿筋拉伤 前交叉韧带重建术 关节镜检查
作者
Yu Li,Hao Zhang,Shizhuo Xiao,Qiu Zheng,Yalan Zeng,Hongbin Yang
出处
期刊:PubMed 卷期号:34 (8): 1018-1024
标识
DOI:10.7507/1002-1892.201908051
摘要

To compare the effectiveness of arthroscopic one-stage reconstruction of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) with LARS artificial ligament and autogenous hamstring tendon, respectively.A retrospective study was performed on 23 patients with ACL and PCL injuries, who were treated with one-stage reconstruction, between June 2013 and June 2017. The ACL and PCL were reconstructed with LARS artificial ligament in 11 patients (artificial ligament group) and autogenous hamstring tendon in 12 patients (autogenous tendon group). There was no significant difference in gender, age, side of injury, cause of injury, time from injury to operation, and preoperative Lysholm score and International Knee Documentation Committee (IKDC) score between the two groups ( P>0.05). The operation time, the time of recovery of daily activities and preoperative exercise level, the occurrence of surgical-related complications, Lysholm score, IKDC score, and the results of knee stability assessment were recorded and compared between the two groups.The operation time and the time of recovery of daily activities and preoperative exercise level were significantly shorter in artificial ligament group than in autogenous tendon group ( P<0.05). All incisions healed primarily. In autogenous tendon group, the common fibular nerve injury occurred in 1 case and intermuscular vein thrombosis occurred in 1 case. No complication occurred in the remaining patients of the two groups. All the patients were followed up 24-54 months (mean, 36.4 months). At last follow-up, the Lysholm score and IKDC score of the two groups were significantly higher than preoperative scores ( P<0.05). There was no significant difference between the two groups ( P>0.05). The varus and valgus stress tests of the two groups were negative. There was no significant difference in anterior drawer test, posterior drawer test, and Lachman test between the two groups ( P>0.05).The effectiveness of arthroscopic one-stage reconstruction of ACL and PCL with LARS artificial ligament or autogenous hamstring tendon was similar. The knee function and stability recover well. But the patients with LARS artificial ligament reconstruction can resume daily activities and return to exercise earlier.比较关节镜下 LARS 人工韧带与自体腘绳肌腱一期重建前交叉韧带(anterior cruciate ligament,ACL)和后交叉韧带(posterior cruciate ligament,PCL)的临床疗效。.回顾分析 2013 年 6 月—2017 年 6 月一期重建 ACL 及 PCL 治疗的 23 例患者临床资料。其中,采用 LARS 人工韧带重建 11 例(人工韧带组),自体腘绳肌腱重建 12 例(自体肌腱组)。两组患者性别、年龄、损伤侧别、致伤原因、受伤至手术时间以及术前 Lysholm 评分、国际膝关节文献委员会(IKDC)评分比较,差异均无统计学意义( P>0.05)。记录并比较两组手术时间、患者术后恢复日常活动及术前运动水平时间,手术相关并发症发生情况,膝关节功能 Lysholm 评分及 IKDC 评分,以及膝关节稳定性评定结果。.人工韧带组手术时间以及患者术后恢复日常活动、术前运动水平时间,均较自体肌腱组明显缩短( P<0.05)。两组术后切口均 Ⅰ 期愈合。自体肌腱组 1 例术后出现腓总神经损伤表现、1 例肌间静脉血栓形成,两组其余患者均无并发症发生。两组患者均获随访,随访时间 24~54 个月,平均 36.4 个月。末次随访时,两组 Lysholm、IKDC 评分均较术前显著提高( P<0.05);两组间差异均无统计学意义( P>0.05)。两组内、外翻应力试验均为阴性;前、后抽屉试验及 Lachman 试验组间比较差异均无统计学意义( P>0.05)。.关节镜下应用 LARS 人工韧带或自体腘绳肌腱一期重建 ACL 及 PCL 的疗效相似,均恢复了膝关节功能与稳定性,但采用前者重建的患者能够更早恢复日常活动及重返运动。.
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