【摘要】 目的 探讨在过短股骨骨道的膝关节镜下前交叉韧带重建术中使用固定襻和可调节襻的疗效。方法2019年1月～2020年7月我院行膝关节镜下前交叉韧带重建术493例，其中股骨骨道<30 mm共57例，最终纳入47例，按股骨端移植物固定方式分为EndoButton组(n=31)和TightRope组(n=16),分别于术后6、12个月采用国际膝关节文献委员会(International Knee Documentation Committee, IKDC)评分、Lysholm评分和Tegner评分评估功能，术后12个月采用Lachman试验和前抽屉试验评估关节松弛度，比较2种固定方式的临床效果。结果 术后第6个月EndoButton组和TightRope组IKDC评分分别为(64.1±11.0)、(62.6±9.2)分，差异无显著性(t=0.464,P=0.645);Lysholm评分分别为(81.9±10.6)、(85.3±9.3)分，差异无显著性(t=-1.079,P=0.286);Tegner评分分别为(2.2±0.9)、(1.9±0.9)分，差异无显著性(t=0.933,P=0.356)。术后第12个月EndoButton组和TightRope组IKDC评分分别为(81.4±9.9)、(78.2±9.2)分，差异无显著性(t=1.068,P=0.291);Lysholm评分分别为(94.6±6.1)、(93.4±7.4)分，差异无显著性(t=0.626,P=0.534);Tegner评分分别为(3.8±1.0)、(3.4±1.2)分，差异无显著性(t=1.402,P=0.168)。2组术后12个月Lachman试验和前抽屉试验比较差异无显著性(Z=-0.039,P=0.969;Z=-0.294,P=0.769)。结论 膝关节镜下前交叉韧带重建术中，对于股骨骨道过短(<30 mm),应用EndoButton(15 mm)或TightRope均能达到良好的临床效果。更多还原

【Abstract】 Objective To explore the efficacy of fixed-loop fixation and adjustable-loop fixation in arthroscopic anterior cruciate ligament(ACL) reconstruction with excessively short femoral tunnel. Methods A total of 493 patients undergoing ACL reconstruction at our hospital from January 2019 to July 2020 were reviewed, including 57 patients with femoral tunnel <30 mm and 47 patients ultimately included. According to the fixation method, they were divided into EndoButton group(n=31) and TightRope group(n=16). The International Knee Documentation Committee(IKDC) score, Lysholm score, and Tegner score were used to evaluate joint function at 6 and 12 months postoperatively, respectively. The Lachman test and anterior drawer test were used to evaluate joint laxity at 12 months postoperatively. The clinical effects of the two fixation methods were compared. Results At 6 months postoperatively, the IKDC scores of the EndoButton group and TightRope group were(64.1±11.0) points and(62.6±9.2) points, respectively, with no significant difference(t=0.464, P=0.645). The Lysholm scores were(81.9±10.6) points and(85.3±9.3) points, with no significant difference(t=-1.079, P=0.286). The Tegner scores were(2.2±0.9) points and(1.9±0.9) points, with no statistically significant difference(t=0.933, P=0.356). At 12 months postoperatively, the IKDC scores of the EndoButton group and TightRope group were(81.4±9.3) points and(78.2±9.2) points, with no statistically significant difference(t=1.068, P=0.291). The Lysholm scores were(94.6±6.1) points and(93.4±7.4) points, with no statistically significant difference(t=0.626, P=0.534). The Tegner scores were(3.8±1.0) points and(3.4±1.2) points, with no statistically significant difference(t=1.402, P=0.168). There was no significant difference in the Lachman test and front drawer test between the two groups at 12 months after surgery(Z=-0.039, P=0.969; Z=-0.294, P=0.769). Conclusion In arthroscopic ACL reconstruction surgery, both EndoButton(15 mm) and TightRope can achieve good clinical results for excessively short femoral tunnel(<30 mm).更多还原