The Efficacy Analysis Of The Allogenic Tendon For Knee Cruciate Ligament Reconstruction By Arthroscope

Knee cruciate ligament injury is a common sportive and traumaticdisease, which can lead to instability of the knee and affect the patients’ dailylife and movement function, at the same time, it also can cause thecorresponding complications and the consequence is very serious. Before the1980’s, the major therapy of the knee cruciate ligament injuries wasnon-surgical method which use the type of gypsum fixed, and could obtain thesatisfactory curative effect. With the general application of arthroscopy andarthroscopic technology unceasing development and improvement, thereconstruction of the cruciate ligament using arthroscopy has been becomingthe accepted treatment currently. The main reconstructive grafts containautograft, allograft and artificial ligament, etc. All the time, the choice ofreconstructive grafts is always one of the important factors which restricted theknee cruciate ligament reconstruction operation success or not, also thereasearchful focus in the recent several decades. Autograft once was consideredas the gold standard applied to the cruciate ligament reconstruction. However,along with the cruciate ligament injury incidence is rising year by year, thecruciate ligament damage has become more and more complicated, usingautografts reconstruct cruciate ligament has also gradually exposed theshortcomings (such as patellar softening, patella fracture, anterior patella pain,patella-tendon rupture, quadriceps femoris atrophy, etc). Sometimes it is hardfor us to meet the reconstruction needs and the development of the artificialligament and the tissue engineering ligament has not became mature. Therefore,allograft tissue has been got the attention of clinical workers more and more, and obtained a large clinical applications.Objective: To analyze and evaluate the clinical outcome of reconstructionof anterior and posterior knee curciate ligament by using allogenic tendonthrough arthroscope.Method: Applying the medical record system of the first hospital of JilinUniversity, retrieving the cases from January2009to June2011in departmentof orthopedic surgery of our hospital which received the arthroscopic allogenictendon for knee cruciate ligament reconstruction, total34cases. It is dividedinto two groups, A group: ACL reconstruction24cases, male19cases, female5cases, aged17to45years old, average of31.83±9.57years;10cases of leftknee, right knee in14cases; Group B: PCL reconstruction10cases, male8cases, femal2cases, aging from18-42years, average of27.20±7.59years;cases of left knee, right knee in2cases. All cases had the explicittrauma history (sports injury, fall, etc), and received physical examination inpreoperative and postoperative time: the drawer test and Lachaman test,Lysholm score, Tegner score. First of all, A and B two groups’ Lysholm scoreand Tegner score in preoperative time and postoperative6months、12monthsand18months taked statistical comparison, P>0.05, had no statisticaldifference. So the whole34patients’ Lysholm score, Tegner score ofpreoperative time and postoperative6months、12months and18months,respectively, did statistical analysis (Differences were statistically significantwhile P<0.05), drawed the corresponding conclusions.Result: All cases got the postoperative6months、12months and18months follow-up. Incisions of all patients healed well, preoperative symptomsand signs almost disappeared and the joint of knee recovered good function andstability. During the follow-up time, there were no serve immunologicalrejection and the corresponding complications. One of patients had due to fallin postoperative5months, came back to exmine and the anterior drawer test were weak positive in postoperative follow-up6months, once again, thearthroscopic surgery exploration had seen the transplanted ligament normal. Sotold the patients to reduce activities and did functional exercise in bed, after6months the sign disappeared. Lysholm score and Tegner score of all patients inpostoperative6months、12months、and18months respectively is:85.70±4.76、7.35±1.09、91.88±3.06、8.58±0.78、93.02±3.01、8.91±0.51，hadobviously improved compared with preoperative43.97±7.79、2.44±0.89（P＜0.05）.But the postoperative Lysholm score and Tegner score in12monthsand18months had no statistical differences（P＞0.05）.Conclusion: The short-term curative effect of arthroscopic allogenictendon for knee cruciate ligament reconstruction is reliable, the stability andfunction of the knee are very good. It has advantages in terms of easyoperation、small injury、and less complications、recover quickly, and avoid thecomplications of autografts. But the mid-term and long-term curative effectneed to further follow-up and research.