关节镜下自体腓骨长肌腱和腘绳肌腱重建前交叉韧带的对比研究

Comparative research on reconstruction of anterior cruciate ligament by autogenous peroneus longus tendon and hamstring tendon ligament under arthroscope

摘要:

目的 比较自体腓骨长肌腱（PLT）与腘绳肌腱（HT）重建前交叉韧带的临床疗效。方法 回顾性分析桂林市中医医院2017年8月－2019年12月收治的56例前交叉韧带损伤患者的临床资料。其中，男26例，女30例，20例行自体PLT重建前交叉韧带（PLT组），36例行HT重建前交叉韧带（HT组）。在术前及术后6和12个月，对所有患者的手术时间、手术切口长度、合并半月板损伤、受伤时间、体重指数（BMI）等进行分析，并用国际膝关节文献委员会（IKDC）评分、Lysholm评分和Tegner评分对患者膝关节运动功能进行评估。结果 HT组手术时间和手术切口长度均较PLT组长，差异有统计学意义（P < 0.05）；两组患者术后6和12个月IKDC评分、Lysholm评分和Tegner评与术前比较，差异均有统计学意义（P < 0.05），但术后6和12个月比较，差异均无统计学意义（P > 0.05）。结论 自体PLT重建前交叉韧带较HT重建前交叉韧带用时少、创伤小、更加美观，且操作简单、并发症少，术后疗效确切，可作为移植物替代HT行前交叉韧带断裂重建。

Abstract:

Objective To compare the clinical effect of anterior cruciate ligament reconstruction with hamstring tendon (HT) and autologous peroneus longus tendon (PLT).Methods The clinical data of 56 patients with anterior cruciate ligament injury from August 2017 to December 2019 were retrospectively analyzed. Including 26 males and 30 females. Among them, 20 patients were treated with autologous PLT for anterior cruciate ligament reconstruction (PLT group), and the remaining 36 patients were treated with HT for anterior cruciate ligament reconstruction (HT group). Before operation, 6 months and 12 months after operation, the operation time, incision length, meniscus injury, injury time and body mass index (BMI) of all patients were analyzed, and International Knee Document Committee (IKDC) score, Lysholm score, Tegner score and knee joint motor function were evaluated.Results The operative time and incision length were longer in HT group than in PLT group, there were significant differences between the two groups (P < 0.05); There were significant differences in IKDC score, Lysholm score and Tegner score before operation compared with 6 months and 12 months after operation in the two groups (P < 0.05), but there was no significant difference between 6 months and 12 months after operation in the two groups (P > 0.05).Conclusion Compared with hamstring tendon reconstruction, anterior cruciate ligament reconstruction using autologous PLT takes less time, has less trauma, and is more beautiful. Besides, the operation is simple, the complications are fewer, and the postoperative efficacy is definite. Therefore, autologous PLT can be used as a graft to replace HT for anterior cruciate ligament rupture reconstruction.