摘要
目的探讨关节镜下锁扣带袢钛板(TightRope)固定结合自体腘绳肌腱在前交叉韧带(ACL)重建中效果观察。方法以2016年1月-2019年8月就诊我院的60例前交叉韧带断裂患者作为研究对象,采用随机数字法平均分为TightRope组与可吸收螺钉组。所有患者均关节镜下自体腘绳肌腱单束解剖重建ACL,胫骨端固定均为可吸收界面螺钉加门形钉,股骨端固定TightRope组行锁扣带袢钛板TightRope固定,可吸收螺钉组行吸收界面螺钉固定。随访评估两组患者术前、术后抽屉试验、Lachman试验、轴移试验、Lysholm评分及IKDC评分结果,并影像CT测量骨隧道扩大情况。结果2组患者术后抽屉试验、Lachman试验及轴移试验阳性率均为0;术后前抽屉移位距离均为阴性,随访6个月差异无统计学意义(P>0.05)。术后3个月及术后6个月TightRope组关节活动度、Lysholm评分与IKDC评分均高于可吸收螺钉组(P<0.05)。2组术后3个月及术后6月关节活动度、Lysholm评分与IKDC评分均高于术前(P<0.05);2组术后6个月关节活动度、Lysholm评分与IKDC评分均高于术后3个月(P<0.05)。术后1年可吸收螺钉组股骨骨隧道扩大比例较TightRope组高(P<0.05);胫骨骨隧道扩大例数较TightRope组多,但差异无统计学意义(P>0.05)。结论关节镜下锁扣带袢钛板固定结合自体腘绳肌腱可以较好的重建ACL,恢复膝关节稳定性,且术后股骨骨隧道扩大风险更低。
Objective To observe of the effect of locking with iliac titanium plate and autologous hamstring tendon of arthroscopy in reconstruction of anterior cruciate ligament.Methods A total of 60 patients with anterior cruciate ligament rupture who were treated from January 2016 to August 2019 were selected as the research objects,and were divided into the TightRope group and the absorbable screw group by random number method.All patients underwent arthroscopic autologous hamstring tendon anatomy and reconstruction of ACL.The tibial ends were fixed with absorbable interface screws and portal nails.The femoral ends in TightRope group were fixed with TightRope group with locking tab and titanium plate TightRope.The femoral ends in absorbable screw group were fixed with absorption interface screws.Follow-up evaluation of the two groups of patients before and after the drawer test,Lachman test,axis shift test,Lysholm score and IKDC score results,and imaging CT to measure the bone tunnel expansion.Results The positive rates of postoperative drawer test,Lachman test,and axial shift test were 0 in the two groups.The front drawer shift distance was negative after follow-up.There was no significant difference in follow-up at 6 months(P>0.05).The joint mobility,Lysholm score,and IKDC score in the TightRope group at 3 and 6 months after operation were higher than those in the absorbable screw group(P<0.05).Joint mobility,Lysholm score,and IKDC score were higher in both groups at 3 and 6 months after operation than before surgery(P<0.05).Joint mobility,Lysholm score,and IKDC score were higher in both groups after surgery at 6 monthsthan after 3 months(P<0.05).One year after operation,the proportion of femoral tunnel enlargement in the absorbable screw group was higher than that in the TightRope group(P<0.05).The number of tibia tunnel enlargement cases was more than that in the TightRope group,but there was no significant difference(P>0.05).Conclusion Arthroscopic locking band loop titanium plate fixation combined with autogenous h
作者
刘松浪
王军
赖兵
林伟明
LIU Songlang;WANG Jun;LAI Bing(Department of Joint Surgery,Meizhou People's Hospital,Guangdong Meizhou,514000,China)
出处
《江西医药》
CAS
2020年第5期504-507,共4页
Jiangxi Medical Journal
基金
广东省梅州市科技计划项目,编号2016B007。
关键词
关节镜
锁扣带袢钛板
腘绳肌腱
前交叉韧带
Arthroscopy
Sacral titanium plate
Hamstring tendon
Anterior cruciate ligament
