中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (8): 1479-1482.doi: 10.3969/j.issn.1673-8225.2010.08.036

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

异体肌腱材料选择及应用Tibial-inlay技术重建膝关节后交叉韧带17例

李志怀，冯  震，张义龙，孙  勃，王  培   

  1. 承德医学院附属医院骨一科，河北省承德市  067000
  • 出版日期:2010-02-19 发布日期:2010-02-19
  • 通讯作者: 王 培，承德医学院附属医院骨一科，河北省承德市 067000 cdgkwp@sina.com.cn
  • 作者简介:李志怀，男，1964年生，河北省承德市人，满族，1987年河北医科大学毕业，副主任医师，主要从事关节镜及脊柱等方面的研究。

Allogenic tendon materials and Tibial-inlay technique for posterior cruciate ligament reconstruction of the knee joint in 17 cases

Li Zhi-huai, Feng Zhen, Zhang Yi-long, Sun Bo, Wang Pei   

  1. First Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde   067000, Hebei Province, China
  • Online:2010-02-19 Published:2010-02-19
  • Contact: Wang Pei, First Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China cdgkwp@sina.com.cn
  • About author:Li Zhi-huai, Associate chief physician, First Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China

PDF

414

被引次数

14

摘要：

背景：自体肌腱移植重建后交叉韧带存在供体区域并发症等问题，虽然人工腱的研制与组织工程腱的研究有了长足的进展，但在临床应用上尚存在一些问题。自20世纪80年代起，同种异体肌腱移植的相关研究逐渐被人们所重视。

目的：同种异体肌腱材料的选择及其应用于重建膝关节后交叉韧带的效果。

方法：17例膝关节后叉韧带损伤患者均使用深低温冷冻同种异体肌腱应用Tibial-inlay技术重建后交叉韧带。术中将用庆大霉素盐水浸泡过15min的两束异体肌腱对折，肌腱的一端套入松质骨螺钉加垫片固定在后叉韧带的胫骨附着点处，另一端通过牵引线引入关节内，修复切开的后关节囊。变换体位为平卧位，患膝屈曲90°，从关节内将移植物的另一端引入股骨隧道，前抽屉拉紧后由外向内拧入挤压螺钉固定。

结果与结论：术前后抽屉试验均>2+，其中3+程度7例，4+程度6例，术后后抽屉试验结果0为4例，1+为8例，2+为4例，3+为1例，显示患者膝关节的后移程度较术前有明显改善。患者术前的Lysholm关节评分为(48.5±4.3)分，术后Lysholm关节评分为(88.3±5.4)分。说明深低温冷冻异体肌腱应用Tibial-inlay技术修复膝关节后交叉韧带不损伤正常的自身结构，可恢复后交叉韧带的功能，治疗效果满意。

关键词: 同种异体肌腱, Tibial-inlay, 后交叉韧带, 深低温冷冻, 生物材料

Abstract:

BACKGROUND: Donor complications have been detected following autologous tendon transplantation for posterior cruciate ligament reconstruction. Although artificial tendon development and tissue-engineered tendon have achieved great progresses, there are some issues in clinical application. Since 1980’s, allogenic tendon transplantation has aroused increasing attention.
OBJECTIVE: To explore the selection of allogenic tendon materials and the effect of their application on reconstructing posterior cruciate ligament.
METHODS: A total of 17 patients with posterior cruciate ligament injury of knee joint were treated with cryopreserved allogenic tendon by Tibial-inlay technique. During the operation, two tracts of tendons soaked in gentamicin saline for 15 minutes were conduplicated, and one end of the tendon was cancellous bone screw and fixed to the tibia attachment point of posterior cruciate ligament, and the other end was introduced into the joint through retention suture. The posterior joint capsule was repaired. The patient was placed at supine position, and the knee was flexed for 90°. The other end of the graft was introduced to femoral tunnel, and anterior drawer was tensed, and fixed by screw.
RESULTS AND CONCLUSIN: The preoperative posterior drawer test of patients was >2+, including 7 cases of 3+ and 6 of 4+. The postoperative posterior drawer test was 0 in 4 cases, 1+ in 8 cases, 2+ in 4 cases and 3+ in 1 case, suggesting the posterior movement of the knee joint was significantly improved. Lysholm scores of patients were (48.5±4.3) points before operation and (88.3±5.4) points after operation. Results show that cryopreserved allogenic tendon by Tibial-inlay technique could restored function of posterior cruciate ligament with a favorable effect.

中图分类号: