[1]徐军鹏,殷杰,秋月,等.腓骨长肌腱与腘绳肌腱行前十字韧带重建术治疗前十字韧带损伤疗效比较[J].新乡医学院学报,2022,39(10):919-923.[doi:10.7683/xxyxyxb.2022.10.004]
 XU Junpeng,YIN Jie,QIU Yue,et al.Comparison of the efficacy of anterior cruciate ligament reconstruction using peroneus longus tendon and hamstring tendon in the treatment of anterior cruciate ligament injury[J].Journal of Xinxiang Medical University,2022,39(10):919-923.[doi:10.7683/xxyxyxb.2022.10.004]
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腓骨长肌腱与腘绳肌腱行前十字韧带重建术治疗前十字韧带损伤疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年10
页码:
919-923
栏目:
临床研究
出版日期:
2022-10-05

文章信息/Info

Title:
Comparison of the efficacy of anterior cruciate ligament reconstruction using peroneus longus tendon and hamstring tendon in the treatment of anterior cruciate ligament injury
作者:
徐军鹏殷杰秋月封慧玲
(中国人民解放军联勤保障部队第987医院骨科,陕西 宝鸡 721000)
Author(s):
XU JunpengYIN JieQIU YueFENG Huiling
(Department of Orthopedics,the 987th Hospital of PLA Joint Logistics Support Force,Baoji 721000,Shaanxi Province,China)
关键词:
腓骨长肌腱腘绳肌腱前十字韧带重建膝关节功能
Keywords:
peroneal longus tendonhamstring tendonanterior cruciate ligament reconstructionknee joint function
分类号:
R687.4
DOI:
10.7683/xxyxyxb.2022.10.004
文献标志码:
A
摘要:
目的 比较腓骨长肌腱与腘绳肌腱行前十字韧带(ACL)重建术治疗前十字韧带损伤的疗效。方法 选择2016年5月至2019年5月于中国人民解放军联勤保障部队第987医院行ACL重建术治疗的ACL损伤患者106例为研究对象,根据移植材料将患者分为腓骨长肌腱组(n=56)和腘绳肌腱组(n=50)。腓骨长肌腱组患者采用自体腓骨长肌腱移植行ACL重建术,腘绳肌腱组患者采用自体腓骨长肌腱移植行ACL重建术。记录2组患者的手术时间、术中出血量、术后24 h引流量和住院时间。分别于术前及术后6个月,采用Lysholm评分量表评估2组患者的膝关节功能,采用Tegner 膝关节运动评分评估2组患者的膝关节运动水平。记录2组患者术后住院期间并发症发生情况,并计算并发症发生率。结果 腓骨长肌腱组患者的手术时间显著长于腘绳肌腱组(P<0.05);腓骨长肌腱组与腘绳肌腱组患者的术中出血量、术后24 h引流量及住院时间比较差异无统计学意义(P>0.05)。2组患者术前Lysholm评分量表中的跛行、支持、绞锁、不稳定、肿胀程度、上楼能力、下蹲能力、疼痛程度评分及总分比较差异无统计学意义(P>0.05); 2组患者术后6个月Lysholm评分量表中的跛行、支持、绞锁、不稳定、上楼能力、肿胀程度、下蹲能力、疼痛程度评分及总分显著高于术前(P<0.05);术后6个月,腓骨长肌腱组患者Lysholm评分量表中的跛行、支持、不稳定、下蹲能力评分及总分显著高于腘绳肌腱组(P<0.05)。2组患者术前Tegner评分比较差异无统计学意义(P>0.05);2组患者术后6个月Tegner评分均显著高于术前(P<0.05);术后6个月,腓骨长肌腱组患者的Tegner评分显著高于腘绳肌腱组(P<0.05)。腘绳肌腱组和腓骨肌腱组患者术后并发症发生率分别为 2.00%(1/56)、5.36%(3/56),2组患者的术后并发症发生率比较差异无统计学意义(χ2=1.037,P>0.05)。结论 相较于腘绳肌腱,应用腓骨长肌腱对ACL损伤患者行ACL重建术手术时间较长,但术后膝关节功能尤其是膝关节运动功能恢复效果更好,且未增加术后并发症。
Abstract:
Objective To compare the efficacy of anterior cruciate ligament (ACL) reconstruction using peroneus longus tendon and hamstring tendon in the treatment of ACL injury.Methods A total of 106 patients with ACL injury who underwent ACL reconstruction from May 2016 to May 2019 in the 987th Hospital of PLA Joint Logistics Support Force were selected as the research objects,and the patients were divided into the peroneus longus tendon group (n=56) and the hamstring tendon group (n=50) according to the graft material.The patients in the peroneus longus tendon group were treated with ACL reconstruction using autologous peroneus longus tendon transplantation,and the patients in the hamstring tendon group were treated with ACL reconstruction using autologous peroneus longus tendon transplantation.The operation time,intraoperative blood loss,drainage volume within 24 hours after operation and hospitalization time of patients in the two groups were recorded.Before operation and 6 months after operation,the knee joint function of patients in the two groups was evaluated by the Lysholm scale;the knee joint movement function of patients in the two groups was evaluated by the Tegner knee joint movement score.The incidence of complications of patients during postoperative hospitalization in the two groups was recorded,and the incidence of complications was calculated.Results The operation time of the patients in the peroneus longus tendon group was significantly longer than that in the hamstring tendon group (P<0.05).There was no significant difference in intraoperative blood loss,drainage volume within 24 hours after operation and the hospitalization time of patients between the peroneus longus tendon group and the hamstring tendon group (P>0.05).Before operation,there was no significant difference in the Lysholm scale of claudication,support,twist,instability,swelling degree,ability to go upstairs,ability to squat,pain degree scores and total score of patients between the two groups (P>0.05).The claudication,support,hinge,instability,degree of swelling,ability to go upstairs,ability to squat,degree of pain scores and the total score in the Lysholm scale of patients in the two groups after 6 months of operation were significantly higher than those before operation (P<0.05);after 6 months of operation,the claudication,support,instability,squatting ability scores and total score in the Lysholm score of patients in the peroneus longus tendon group were significantly higher than those in the hamstring tendon group (P<0.05).Before operation,there was no significant difference in the Tegner score of patients between the two groups (P>0.05);the Tegner scores of patients in the two groups after 6 months of operation were significantly higher than those before operation (P<0.05);after 6 months of operation,the Tegner score of patients in the peroneus longus tendon group was significantly higher than that in the hamstring tendon group (P<0.05).The incidence of postoperative complication in the hamstring tendon group and the peroneus tendon group were 2.00% (1/56) and 5.36% (3/56),respectively;there was no significant difference in the incidence of postoperative complication of patients between the two groups (χ2=1.037,P>0.05).Conclusion Compared with the hamstring tendon,the peroneus longus tendon for ACL reconstruction in patients with ACL injury has longer operation time,but the postoperative recovery of knee joint function,especially the knee joint motor function is better,and the incidence of postoperative complications is not increased.

参考文献/References:

[1] 马英,冯华,宋关阳,等.前十字韧带损伤后胫骨过度前移对重建术后膝关节稳定性的影响[J].中华骨科杂志,2019,39(7):392-397.
MA Y,FENG H,SONG G Y,et al.The effects of excessive preperative anterior tibial translation on post-operative knee stability after anterior cruciate ligament reconstruction[J].Chin J Orthop,2019,39(7):392-397.
[2] 宋关阳,张辉,刘心,等.伴有高度轴移现象的前十字韧带损伤患者前外侧韧带MRI信号异常的发生率[J].中华骨科杂志,2018,38(7):385-389.
SONG G Y,ZHANG H,LIU X,et al.Incidence of concomitant anterolateral ligament MRI abnormality on patients with high-grade pivot-shift phenomenon[J].Chin J Orthop,2018,38(7):385-389.
[3] 倪乾坤,张辉,宋关阳,等.非接触性前十字韧带损伤初次重建术后失效的危险因素[J].中华骨科杂志,2020,40(7):389-396.
NI Q K,ZHANG H,SONG G Y,et al.Risk factors for primary anterior cruciate ligament reconstruction failure [J].Chin J Orthop,2020,40(7):389-396.
[4] JOHNSTON J T,MANDELBAUM B R,SCHUB D,et al.Video analysis of anterior cruciate ligament tears in professional american football athletes[J].Am J Sports Med,2018,46(4):862-868.
[5] GRASSI A,ZAFFAGNINI S.Meta-analysis of the risk of infections after anterior cruciate ligament reconstruction by graft type:letter to editor[J].Am J Sports Med,2018,46(5):NP20-NP21.
[6] KAY J,MEMON M,MARX R G,et al.Over 90% of children and adolescents return to sport after anterior cruciate ligament reconstruction:a systematic review and meta-analysis[J].Knee Surg Sports Traumatol Arthrosc,2018,26(4):1019-1036.
[7] LEO M,CAZZATO D,DE MARCO T,et al.Unsupervised eye pupil localization through differential geometry and local self-similarity matching[J].PLoS One,2014,9(8):e102829.
[8] PAPALIA R,FRANCESCHI F,VASTA S,et al.Sparing the anterior cruciate ligament remnant:is it worth the hassle[J].Br Med Bull,2012,104:91-111.
[9] MARTIN S D,MARTIN T L,BROWN C H.Anterior cruciate ligament graft fixation[J].Orthop Clin North Am,2002,33(4):685-696.
[10] PARCHI P D,CIAPINI G,PAGLIALUNGA C,et al.Anterior cruciate ligament reconstruction with lars artificial ligament-clinical results after a long-term follow-up[J].Joints,2018,6(2):75-79.
[11] ERICKSON B J,HARRIS J D,FILLINGHAM Y A,et al.Performance and return to sport after anterior cruciate ligament reconstruction in X-games skiers and snowboarders[J].Orthop J Sports Med,2013,1(6):2325967113511196.
[12] PRENTICE H A,LIND M,MOUTON C,et al.Patient demographic and surgical characteristics in anterior cruciate ligament reconstruction:a description of registries from six countries[J].Br J Sports Med,2018,52(11):716-722.
[13] UFFMANN W,ELATTRACHE N,NELSON T,et al.Posterior lateral meniscal root tears increase strain on the reconstructed anterior cruciate ligament:a cadaveric study[J].Arthrosc Sports Med Rehabil,2021,3(2):e505-e513.
[14] ZACHARIAS A J,WHITAKER J R,COLLOFELLO B S,et al.Secondary injuries after pediatric anterior cruciate ligament reconstruction:a systematic review with quantitative analysis[J].Am J Sports Med,2021,49(4):1086-1093.
[15] BODKIN S G,HERTEL J,HART J M.Gaze accuracy differences during single-leg balance following anterior cruciate ligament reconstruction[J].J Sport Rehabil,2021,30(5):737-743.
[16] BISSON L J.Editorial commentary:quadriceps tendon all-soft-tissue graft for anterior cruciate ligament reconstruction:more information about a newer surgical nail[J].Arthroscopy,2021,37(3):1053-1054.
[17] COSTA-PAZ M,MUSCOLO D L,AYERZA M A,et al.Mucormycosis osteomyelitis after anterior cruciate ligament reconstruction:treatment and outcomes of 21 reported cases[J].Bone Jt Open,2021,2(1):3-8.
[18] BABALOLA O R,ITAKPE S E,AFOLAYAN T H,et al.Predictive value of clinical and magnetic resonance image findings in the diagnosis of meniscal and anterior cruciate ligament injuries[J].West Afr J Med,2021,38(1):853-856.
[19] KEIZER M N J,OTTEN E,BEIJERSBERGEN C M I,et al.Copers and noncopers use different landing techniques to limit anterior tibial translation after anterior cruciate ligament reconstruction[J].Orthop J Sports Med,2021,9(4):2325967121998061.
[20] CUZZOLIN M,PREVITALI D,DELCOGLIANO M,et al.Independent versus transtibial drilling in anterior cruciate ligament reconstruction:a meta-analysis with meta-regression[J].Orthop J Sports Med,2021,9(7):23259671211015616 .
[21] NAPIER R J,FELLER J A,DEVITT B M,et al.Is the KiRA device useful in quantifying the pivot shift in anterior cruciate ligament-deficient knees[J].Orthop J Sports Med,2021,9(1):2325967120977869.
[22] JAIN G,DATT R,MAHMOOD A,et al.Anteromedial portal reference technique for femoral tunnel depth measurement during arthroscopic anterior cruciate ligament reconstruction[J].Cureus,2021,13(2):e13147.

更新日期/Last Update: 2022-10-05