LARS韧带与异体胫前肌腱保残重建损伤后交叉韧带的术后疗效对比研究Efficacy of LARS artificial ligament versus tibialis anterior allograft for posterior cruciate ligament reconstruction: a comparative study
李彬;王延芳;邱闯;白伦浩;
摘要(Abstract):
[目的]研究LARS人工韧带与异体胫前肌腱保残重建后交叉韧带(PCL)损伤术后的疗效差异,指导临床治疗。[方法]38例PCL损伤并进行重建的患者,根据术中采用移植物种类分成两组:LARS人工韧带组(19例)和异体胫前肌腱组(19例)。所有患者随访2年。评价指标包括:IKDC评分、Lysholm评分、Tegner评分和膝关节稳定度测量。[结果]与术前相比,两组患者术后的关节稳定性和功能指标均有显著改善(P<0.05)。同时,LARS人工韧带组患者术后的关节稳定性显著强于异体胫前肌腱组(P<0.05),而两组患者术后Lysholm评分、Tegner评分和IKDC评分结果差异无统计学意义(P>0.05)。[结论]采用LARS人工韧带比采用异体胫前肌腱重建损伤的PCL更有利于患膝稳定性的恢复。
关键词(KeyWords): 后交叉韧带;重建;关节镜;LARS人工韧带;胫前肌腱
基金项目(Foundation): 辽宁省自然科学基金优秀人才培育项目(编号:2014021011)
作者(Author): 李彬;王延芳;邱闯;白伦浩;
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DOI:
参考文献(References):
- [1]Almqvist KF,Jan H,Vercruysse C,et al.The tibialis tendon as a valuable anterior cruciate ligament allograft substitute:biomechanical properties[J].Knee Surg Sports Traumatol Arthrosc,2007,15(11):1326-1330.
- [2]Cooper MT,Kaeding C.Comparison of the hospital cost of autograft versus allograft soft-tissue anterior cruciate ligament reconstructions[J].Arthroscopy,2010,26(11):1478-1482.
- [3]Mariscalco MW,Magnussen RA,Mehta D,et al.Autograft versus nonirradiated allograft tissue for anterior cruciate ligament reconstruction:a systematic review[J].Am J Sports Med,2014,42(2):492-499.
- [4]Jung YB,Jung HJ,Yang JJ,et al.Characterization of spontaneous healing of chronic posterior cruciate ligament injury:analysis of instability and magnetic resonance imaging[J].J Magn Reson Imaging,2008,27(6):1336-1340.
- [5]Chen CH.Strategies to enhance tendon graft-bone healing in anterior cruciate ligament reconstruction[J].Chang Gung Med J,2009,32(5):483-493.
- [6]Jung YB,Tae SK,Lee YS,et al.Active non-operative treatment of acute isolated posterior cruciate ligament injury with cylinder cast immobilization[J].Knee Surg Sports Traumatol Arthrosc,2008,16(8):729-733.
- [7]Janssen RP,Scheffler SU.Intra-articular remodelling of hamstring tendon grafts after anteriorcruciate ligament reconstruction[J].Knee Surg Sports Traumatol Arthrosc,2014,22(9):2102-2108.
- [8]Legnani C,Ventura A,Terzaghi C,et al.Anterior cruciate ligament reconstruction with synthetic grafts.A review of literature[J].Int Orthop,2010,34(4):465-471.
- [9]Mulford JS,Chen D.Anterior cruciate ligament reconstruction:a systematic review of polyethylene terephthalate grafts[J].ANZ J Surg,2011,81(11):785-789.
- [10]Liu ZT,Zhang XL,Jiang Y,et al.Four-strand hamstring tendon autograft versus LARS artificial ligament for anterior cruciate ligamentreconstruction[J].Int Orthop,2010,34(1):45-49.
- [11]Savarese A,Lunghi E,Budassi P,et al.Remarks on the complications following ACL reconstruction using synthetic ligaments[J].Ital J Orthop Traumatol,1993,19(1):79-86.
- [12]Olson EJ,Kang JD,Fu FH,et al.The biochemical and histological effects of artificial ligament wear particles:in vitro and in vivo studies[J].Am J Sports Med,1988,16(6):558-570.
- [13]Nau T,Lavoie P,Duval N.A new generation of artificial ligament sinreconstruction of the anterior cruciate ligament two-year follow-up of a randomised trial[J].J Bone Joint Surg Br,2002,84(3):356-360.
- [14]Viateau V,Manassero M,Anagnostou F,et al.Biological and biomechanical evaluation of the ligament advanced reinforcement system(LARS AC)in a sheep model of anterior cruciate ligament replacement:a 3-month and 12-month study[J].Arthroscopy,2013,29(6):1079-1088.
- [15]Parchi PD,Gianluca C,Dolfi L,et al.Anteriorcruciate ligamentreconstruction with LARSTM artificial ligament results at a mean followup of eight years[J].Int Orthop,2013,37(8):1567-1574.
- [16]Trieb K,Blahovec H,Brand G,et al.In vivo andin vitro cellular ingrowth into a new generation of artificial ligaments[J].Eur Surg Res,2004,36(3):148-151.
- [17]Gao K,Chen S,Wang L,et al.Anterior cruciate ligament reconstruction with LARS artificial ligament:a multicenter study with 3-to 5-year follow-up[J].Arthroscopy,2010,26(4):515-523.
- [18]Ahn JH,Wang JH,Lee YS,et al.Anterior cruciate ligament reconstruction using remnant preservation and a femoral tensioning technique:clinical and magnetic resonance imaging results[J].Arthroscopy,2011,27(8):1079-1089.