摘要
背景:LARS人工韧带由法国Laboureau应用聚对苯二甲酸乙二醇酯模仿人体韧带的解剖结构和重物力学原理设计而成,既符合正常前交叉韧带的生理结构,同时又显著提高了抗扭转力,能对抗重复扭曲,弯曲的力以及过度牵引。目的:总结LARS人工韧带在急性膝关节前交叉韧带损伤移植重建中的临床应用特点。方法:选择急性前交叉韧带损伤患者23例,男17例,女6例,年龄21～54岁;受伤至手术时间为3d～3周。均采用法国产聚对苯二甲酸乙二醇酯材料LARS人工韧带对断裂损伤的韧带行重建。植入前后按照Lysholm膝关节评分标准进行评价。结果与结论:23例随访11.2(10～14)个月,所有患膝不稳定症状消失,前后抽屉试验阴性,关节功能良好,平均伸屈度0°～120°;根据Lysholm膝关节评分法,从术前(40.34±4.00)分增加至术后(90.21±4.00)分,差异有显著性意义(P<0.01);均于术后2个月左右恢复一般体育活动。部分病例术后MRI检查发现,残余韧带逐渐长入人工韧带,使其逐渐增粗。证实关节镜下聚对苯二甲酸乙二醇酯材料LARS人工韧带重建前交叉韧带,操作简便,创伤小,可使关节获得即时稳定性,早期康复锻炼,同时残存韧带组织与人工韧带交织保留了本体感觉的神经传导路径,最大限度防止关节功能受限,近期疗效满意。
BACKGROUND：LARS artificial ligament was designed by Laboureau from France using polyethylene terephthalates with the anatomic structure of human ligament and mechanical principle of weight.This ligament is not only accorded with physiological structure of normal anterior cruciate ligament,but also significantly elevates anti-torque,can resist repetitive twist,bend and excessive traction.OBJECTIVE：To summarize characteristics of clinical application of LARS artificial ligament in transplant reconstruction following acute anterior cruciate ligament of knee joint injury.METHODS：A total of 23 patients with acute anterior cruciate ligament injury,comprising 17 males and 6 females,aged 21-54 years,were selected.Time from injury to surgery was 3 days to 3 weeks.Polyethylene terephthalates LARS artificial ligament made in France was used to reconstruct damaged ligament.The transplant was evaluated before and after implantation according to Lysholm knee joint criteria.RESULTS AND CONCLUSION：Following 11.2 months（10-14 months）of follow-up,unstable symptoms of affected knees of all 23 cases disappeared.Anterior and posterior drawer tests were negative,with good joint function.Average extension and flexion degree was 0°-120°.In accordance with Lysholm knee joint score,significant difference was found from（40.34±4.00）points preoperatively to（90.21±4.00）points postoperatively（P0.01）.They could do common athletic activities at about 2 months following surgery.In some cases,magnetic resonance examination demonstrated that residue ligament gradually grew into artificial ligament,which gradually became thicker.Above-mentioned results have verified that under an arthroscope,reconstruction of anterior cruciate ligament using polyethylene terephthalates LARS artificial ligament showed simple operation and small wound,which may lead to immediate stability,early rehabilitation exercises.Simultaneously,interlacing of residue ligament and artificial ligament keeps the nerve conduction pathway of proprioceptive sense,which prevents joint function limitation greatly.Moreover,short-term outcomes are satisfactory.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第16期3011-3014,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
作者简介
张建林，男，1974年生，陕西省延安市人，汉族，延安大学医学院毕业，副主任医师，主要从事关节镜，椎间盘镜研究。zjl1939@163．com
