摘要
目的:腘绳肌腱重建前交叉韧带曾出现过多种固定器材,分析近年来关于腘绳肌腱重建前交叉韧带的文献资料,了解肌腱固定方式的发展趋势。资料来源:通过计算机检索Medline1995-01/2006-09有关腘绳肌腱重建前交叉韧带移植肌腱固定方式的文献,检索词为“anteriorcruciate ligament,reconstruction,hamstring”,限定文章语言种类为English;另外检索中文期刊全文数据库2000-01/2006-03有关腘绳肌腱重建前交叉韧带移植肌腱固定方式的文献,检索词为“前交叉韧带,重建术,腘绳肌腱”,限定文章语言种类为中文。资料选择:选取有关腘绳肌腱重建前交叉韧带的文章,纳入标准:①随机或自身前后对照的临床研究。②观点明确。③有关于固定方式的评论。排除标准:①综述。②重复性研究。资料提炼:共检索到60篇关于腘绳肌腱重建前交叉韧带的文章,选择其中符合标准的33篇进行综合分析。资料综合:固定方式经历了一个由皮质骨外固定到骨隧道内固定的演变过程,Transfix是目前较为理想的固定方式,肌腱结嵌压固定是最新出现的一种固定方式,其临床效果尚需进一步验证。在固定位置的选择上,多数学者认为应该遵循等距重建。通过对固定方式的比较发现,隧道内固定能减轻术后骨隧道的扩大程度。结论:腘绳肌腱重建前交叉韧带的固定方法越来越趋于隧道内固定,并朝着利于腱骨愈合、减轻骨隧道扩大的方向发展。在固定位置的选择上,学者们尚无统一的意见,其趋势可能是向解剖固定发展。
OBJECTIVE： There have been different fixation systems in anterior cruciate ligament reconstruction with hamstring. This review analyzed some of the articles related to anterior cruciate ligament reconstruction with hamstring, and understood the developing tendency of tendon fixation system.
DATA SOURCES： Articles between January 1995 and September 2006 were searched in Medline with the key words of ＂anterior cruciate ligament, reconstruction, hamstring＂, and the language was limited to English. Meanwhile, Chinese articles between January 2000 and March 2006 were searched in Chinese Journal Full-text Database with the key words of ＂anterior cruciate ligament, hamstring, reconstruction＂.
STUDY SELECTION： Articles related to anterior cruciate ligament reconstruction with hamstring were collected. Inclusive criteria： （1）Randomized or self-controlled clinical studies, （2）Definite conclusion, （3）Appraise about fixation system. Exclusive criteria：（1）Reviews, （2）Repeated studies.
DATA EXTRACTION： Totally 60 articles about anterior cruciate ligament reconstruction with hamstring were retrieved, of which 33 in accordance with the inclusive criteria were selected to review.
DATA SYNTHESIS： The fixation system has gone through an evolutionary process of excortical way to inside tunnel way. Currently, transfix is an ideal fixation system. Hamstring knot implant fixation is a newer fixation way, but its clinical effect needs more validation. On the position of fixation, most authors believe in isometric reconstruction. After comparison, authors find that the inside tunnel way could reduce tunnel enlargement.
CONCLUSION： The fixation of hamstring in anterior cruciate ligament reconstruction is tending to inside tunnel ways. And the fixation systems in the future must be benefit to tendon-bone healing and reduction of tunnel enlargement. There is not a consistent opinion about the position of fixation, but it may tend to anatomic fixation.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第16期3140-3143,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
福建省自然科学基金计划资助项目(2006J0387)~~
