前交叉韧带翻修手术的中长期疗效及影响因素分析

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摘要目的〓探究不同移植物用于前交叉韧带翻修的中期疗效，分析影响翻修手术效果的相关因素。方法〓回顾性分析2013年1月至2019年10月唐山市第二医院收治的前交叉韧带重建术后首次翻修的45例患者资料，其中男31例，女14例；年龄20~58岁，平均(38.45±9.54)岁。膝关节功能主观评分采用Lysholm评分和国际膝关节文献委员会(international knee documentation committee，IKDC)评分、Tegner运动评分进行评估，膝关节稳定性采用基于KT-1000侧侧差值评估，关节镜探查软骨损伤情况按照Outerbridge分级评估。结果〓患者术后均获随访，随访时间34~53个月，平均(41.75±8.62)个月。翻修术后1年及末次随访时，患者临床指标较术前均明显改善(P＜0.05)；末次随访时X线片复查，与术前比较部分病例出现明显骨质密度降低，所有患者重建骨隧道无明显扩大，移植物固定装置无明显失效表现。翻修移植物为自体腘绳肌腱、同种异体肌腱的膝关节功能和稳定性评分结果差异无统计学意义(P＞0.05)；关节软骨损伤越重术后临床结果越差，关节软骨损伤＞2级较关节软骨损伤≤2级对术后IKDC评分的影响更明显(P＜0.05)。结论〓前交叉韧带翻修重建可以改善膝关节功能和稳定性；自体腘绳肌腱与同种异体肌腱作为翻修移植物的临床疗效相当。术者经验丰富、移植物直径＞8 mm、关节软骨损伤无或轻度以及充分的手术宣教、积极的心理疏导是前交叉韧带翻修预后的积极因素。

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	刘国立1
	尹向辉1
	戴士峰1
	孙昌俊2

关键词 ：前交叉韧带, 翻修, 同种异体肌腱, 自体腘绳肌腱, 影响因素

基金资助:河北省卫生健康科研基金项目(20221731)

作者简介: 刘国立(1987－ )，男，主治医师，唐山市第二医院关节二科，tslglfly@163.com

引用本文:

刘国立1，尹向辉1，戴士峰1，孙昌俊2. 前交叉韧带翻修手术的中长期疗效及影响因素分析[J]. 实用骨科杂志, 2024, 30(7): 643-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2024/V30/I7/643

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