Chinese Journal of Tissue Engineering Research ›› 2014, Vol. 18 ›› Issue (42): 6827-6831.doi: 10.3969/j.issn.2095-4344.2014.42.020
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Chen Xiao, Huang Jing-min
Revised:
2014-09-15
Online:
2014-10-08
Published:
2014-10-08
About author:
Chen Xiao, Studying for master’s degree, Second Arthroscopy Ward of Sports and Injury, Tianjin 300211, China
CLC Number:
Chen Xiao, Huang Jing-min. Biomechanical characteristics of suturing the ligament end during anterior cruciate ligament reconstruction[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(42): 6827-6831.
2 临床应用 Clinical application 2.1 对象和方法 设计:病例回顾性分析。 时间及地点:2013年7月至2014年6月在天津医院运动与损伤关节镜2病区完成。 对象:2013年7月至2014年6月,本科共施行关节镜下前、后交叉韧带重建术315例,选取了其中125例前交叉韧带重建患者进行临床缝线方式拉力比较,男88例,女37例;年龄(35.3±6.7)岁;均为膝关节运动性损伤。 纳入标准:①膝关节运动性损伤患者。②行关节镜下前交叉韧带重建者。③患者对治疗均知情同意,签署“知情同意书”。 排除标准:膝关节骨性关节炎、类风湿关节炎、肿瘤等。 方法:所有患者施行关节镜下前交叉韧带重建,采用改良的Krackow双锁边缝合法(肌腱缝合线由强生公司提供,商品名爱惜康缝线),移植物的胫骨端全部采用缝线固定,经胫骨骨隧道拉出,在保持移植物张力的情况下,胫骨前面挤压螺钉固定。 3针固定组:在2013年12月以前,62例次采用两条缝线双锁边法缝合3针固定,借鉴张春礼[16]方法,第一针贯穿韧带缝合。 康复计划为:术后当日开始直腿抬高训练;术后7 d佩戴交叉韧带型铰链支具,扶双拐患肢不完全负重下地行走,术后2周30°,3周60°,4周90°,5周120°,2个月可完全负重逐步弃拐行走,3个月去支具,然后恢复自由行走,1年后经医生检查允许后可开始参加体育运动。 5针固定组:2013年12月以后的63例采用两条缝线双锁边法缝合5针固定,第一针同样贯穿韧带,术后功能恢复计划同前。 主要观察指标:①随访时行抽屉试验检查前交叉韧带及后交叉韧带功能。②患者满意率。③不良反应及材料宿主反应。 2.2 结果 2.2.1 参与者数量分析 125例患者肌腱重建后随访2-14个月,平均随访6.4个月,无脱落者,按意向性处理分析,全部进入结果分析。 2.2.2 两组基线资料比较 两组前交叉韧带重建患者的性别、年龄、病程等比较差异无显著性意义(P > 0.05),有可比性,见表1。 2.2.3 随访结果 抽屉试验阳性患者2例,患者满意率99%。3针固定组及5针固定组组间比较差异无显著性意义(P > 0.05)。 2.2.4 不良反应及材料宿主反应 未见早期或晚期缝线断裂松脱,患者康复顺利,无意外情况发生;无二次手术、无伤口感染等并发症发生。"
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