| Objectives By comparing the anatomical and biomechanical characteristics of double strands peroneus longus tendon(PLT)and four strands hamstring tendon(HT)in fresh specimens,and the clinical efficacy of posterior cruciate ligament(PCL)reconstruction with double strands PLT and four strands HT,to explore the safety and effectiveness of PCL reconstruction with double strands PLT,and provide reference for reconstruction of PCL.Methods 1 Experimental research: compared the length and average diameter of PLT and HT;compared the ultimate load strength of double strands PLT,four strands HT and PLC measured on 26 fresh frozen leg specimens.2 Clinical research: from January 2014 to December 2015,45 patients with complete rupture of PCL who were admitted by the Tangshan People's Hospital affiliated to North China University of Science and Technology were divided into the PLT group(A group,24 cases)and the HT group(B group,21cases)according to different grafts.The group A was reconstructed with double strands PLT,and the group B was reconstructed with 4 strands HT.Both groups used the single-bundle reconstruction.Compared the time from the beginning of tendon extraction to completion of the tendon weaving between two groups during the operation.The function of knee was evaluated by the International Knee Documentation Committee(IKDC)score,Lysholm score and Tegner score respectively before operation and 24 months after operation.The tibial posterior shift was measured by KT2000 respectively before operation and 24 months after operation.The function of ankle joint of group A was evaluated by the AOFAS score and Maryland score respectively before operation and 24 months after operation.Results 1 Experimental research showed that the length of double strands PLT and four strands HT were 10.99±1.05 cm and 10.02±0.76 cm,and the differences were statistically significant(P<0.001);the average diameter of double strands PLT and four strands HT were 8.20±0.69 mm and 7.31±0.66 mm,and the differences were statistically significant(P<0.001);the ultimate load strength of double strands PLT,four strands HT and PCL were 2618.48±89.568 N,2584.04±114.23 N and 1949.60±57.04 N,and the differences between double strands PLT and PCL were statistically significant(P<0.001),but there were no statistically significant between double strands PLT and 4 strands HT(P=0.537>0.05).2 Clinical research showed that the time from the beginning of tendon extraction to completion of the tendon weaving during the operation of group A and group B were 21.93±2.13 minute and 26.09±2.21 minute,and the differences were statistically significant(P<0.001).There were no significant differences in IKDC score,Lysholm score,Tegner score,tibial posterior shift between two groups before operation(P>0.05)so the data of two groups were comparability.Compared with preoperation,IKDC score,Lysholm score,Tegner score,tibial posterior shift of patients were significantly improved in two groups 24 months after operation,and the differences were statistically significant(P<0.001);there were no significant differences in IKDC score,Lysholm score,Tegner score,tibial posterior shift between two groups 24 months after operation(P>0.05).There were no significant differences in the AOFAS score and Maryland score between preoperation and 24 months after the operation of group A(P>0.05).Conclusions 1 Double strands PLT is an ideal transplant material for the PCL reconstruction.The length and diameter of double strands PLT are better than those of four strands HT and the ultimate load strength of double strands PLT is similar to that of four strands HT.Double strands PLT can meet the the biomechanical and anatomical requirements of PCL reconstruction.2 The clinical curative effect of reconstruction of PCL with double strands PLT and four strands HT is similar,and both of them are effective methods for the treatment of PCL injury.3 Compared with the four strands HT,the double strands PLT has the advantage of simple and secure tendon extraction. |
PDF Full Text Request