膝关节镜下取自体肌腱重建后交叉韧带的临床疗效分析

doi:10.13418/j.issn.1001-165x.2022.4.17

中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (4): 466-470.doi: 10.13418/j.issn.1001-165x.2022.4.17

膝关节镜下取自体肌腱重建后交叉韧带的临床疗效分析

李炳坤^1，2，张磊^1,2，夏章容^1,2，周鑫^1,2，唐小高^1,2，扶世杰^1,2，汪国友^1,2，黄文华^1,2,3*

1.西南医科大学附属中医医院骨伤科，骨伤疾病研究中心，泸州市专家工作站，四川泸州 646000； 2.广东省医学3D打印应用转化工程技术研究中心西南医科大学附属中医医院临床基地，四川泸州 646000； 3.南方医科大学基础医学院人体解剖学国家重点学科，广州 510515

收稿日期:2020-10-16 出版日期:2022-07-25 发布日期:2022-07-26
通讯作者: 黄文华，教授，博士生导师，E-mail：huangwenhua2009@139.com
作者简介:李炳坤（1995-），男，四川泸州人，医学学士，住院医师，研究方向：中医骨科，E-mail：765095208@qq.com
基金资助:
2018年泸州市人民政府-西南医科大学科技战略合作项目（2018LZXNYD-ZK43）；2019年西南医科大学附属中医医院科研项目（国家自然基金培养项目）（2019XYLH-001）；2020年国家自然科学基金课题（青年科学基金项目）（82004458）；深圳市医疗卫生“三名工程”高层次医学团队（SZSM201612019）

Clinical effect analysis of reconstruction of posterior cruciate ligament from personal tendon under arthroscopy

Li Bingkun^1,2, Zhang Lei^1,2, Xia Zhangrong^1,2, Zhou Xin^1,2, Tang Xiaogao^1,2, Fu Shijie^1,2, Wang Guoyou^1,2, Huang Wenhua^1,2,3*

1.Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Center for Orthopedic Diseases Research, Expert Workstation in Luzhou, Luzhou 646000, Sichuan Province,China; 2.Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou 646000, Sichuan Province, China; 3. Department of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China

Received:2020-10-16 Online:2022-07-25 Published:2022-07-26

摘要/Abstract

摘要： 目的探究关节镜下应用自体腓骨长肌腱和半腱肌腱重建后交叉韧带（posterior cruciate ligament，PCL）手术的临床疗效及预后。方法选取本院后交叉韧带断裂患者33例，予以关节镜下取自体腓骨长肌腱和半腱肌腱重建PCL治疗。比较术前、术后3、6、12个月患者IKDC评分、Lysholm评分、Tegner评分和胫骨后移距离，对患者膝关节的综合功能进行评估。结果患者术后12个月X线片和MRI显示螺钉位置固定可靠，无断裂、松脱及骨道愈合，后抽屉实验转阴性。术后12个月胫骨后移距离较术前明显缩短，（11.33±1.45）cm VS（3.27±0.80）cm，P<0.05；术后3、6、12个月胫骨后移距离有缓慢增长趋势，分别为（2.94±0.90）、（3.18±0.84）及（3.27±0.80）cm，无统计学差异。与术前（50.33±3.31）相比，术后3、6、12个月IKDC评分分别为（70.97±2.59）、（86.18±1.78）、（92.67±2.13），P<0.05；Lysholm评分术前（51.82±3.95），术后3、6、12个月分别为（73.52±2.59）、（87.12±1.93）、（93.94±1.98），P<0.05；Tegner评分术前（1.97±1.10），术后3、6、12个月分别为（5.21±0.74）、（7.67±0.85）、（8.52±0.57），P<0.05。功能明显改善，且评分比较均逐步提高，具有显著性差异。结论在镜下应用自体腓骨长肌腱和半腱肌腱重建后交叉韧带的临床疗效确切，并发症较少，可显著改善膝关节的功能、疼痛和稳定性，值得推荐。

关键词: 关节镜； , , 腓骨长肌腱； , , 半腱肌腱； , , 后交叉韧带重建

Abstract: Objective To investigate the clinical effect and prognosis of reconstruction of posterior cruciate ligament (PCL) with peroneal longus tendon and semitendinosus tendon autografts under arthroscopy. Methods The clinical data of 33 patients who met the inclusion criteria and treated with PCL rupture in the Hospital of Traditional Chinese Medicine Affiliated to Southwest Medical University from June 2018 to May 2019 were retrospectively analyzed. Posterior cruciate ligament reconstruction with autologous peroneus longus tendon and tendon of semitendinosus under arthroscopy were performed. The IKDC score, Lysholm score, Tegner score and the backwards distance of tibial plateau were compared before operation, 3 months, 6 months and 12 months after operation to evaluate comprehensive function of the knee joint. Results The X-ray and MRI of the patient 12 months after operation showed that the screw position was securely fixed without rupture or release, union of bone canal, and the PDT turned negative. The backwards distance of tibial plateau 12 months after operation was obviously shorter than that before operation, (11.33±1.45) cm VS(3.27±0.80) cm, P<0.05. after operation of 3 months, 6 months, and 12 months, The backwards distance of tibial plateau increased slowly at 3, 6, 12 months postoperatively (2.94±0.90), (3.18±0.84) and (3.27±0.80) cm, respectively, without statistical difference. At 3, 6, and 12 months after operation, the IKDC scores were (70.97±2.59), (86.18±1.78), (92.67±2.13), respectively, compared with (50.33±3.31) before operation, P<0.05. Lysholm scores were (73.52±2.59), (87.12±1.93), (93.94±1.98), respectively, compared with (51.82±3.95) before operation, P<0.05. Tegner scores were (5.21±0.74), (7.67±0.85), (8.52±0.57), respectively, compared with (1.97±1.10) before operation, P<0.05 The function was improved significantly, the comparison between scores was gradually increased, with significant difference. Conclusions The clinical effect of posterior cruciate ligament reconstruction with autologous peroneus longus and semitendinosus tendon under arthroscopy is definite with fewer complications. Besides, the surgery can significantly improve knee joint function, pain and stability, which is worthy of recommendation.

Key words: Arthroscopy; , Autologous peroneus longus tendon; , Semitendinosus tendon; , Posterior cruciate ligament reconstruction

中图分类号:

R686.5

李炳坤, 张磊, 夏章容, 周鑫, 唐小高, 扶世杰, 汪国友, 黄文华. 膝关节镜下取自体肌腱重建后交叉韧带的临床疗效分析[J]. 中国临床解剖学杂志, 2022, 40(4): 466-470.

Li Bingkun, Zhang Lei, Xia Zhangrong, Zhou Xin, Tang Xiaogao, Fu Shijie, Wang Guoyou, Huang Wenhua. Clinical effect analysis of reconstruction of posterior cruciate ligament from personal tendon under arthroscopy[J]. Chinese Journal of Clinical Anatomy, 2022, 40(4): 466-470.

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膝关节镜下取自体肌腱重建后交叉韧带的临床疗效分析

Clinical effect analysis of reconstruction of posterior cruciate ligament from personal tendon under arthroscopy

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