MRI评估前交叉韧带重建术后腱骨愈合情况的研究

目的：采用自体四股腘绳肌重建前交叉韧带（Anterior Cruciate Ligament, ACL）术后腱骨愈合程度与临床疗效的相关性研究目前报导较少。本研究的目的是明确自体四股腘绳肌重建ACL术后腱骨愈合程度与临床膝关节功能评分之间是否存在相关性。方法：前瞻性研究我院在2013年4月至2014年4月，30例采用自体四股腘绳肌重建ACL术后腱骨愈合程度及临床功能评分情况。所有患者在术后3、6、12个月分别进行Tegner、Lysholm、国际膝关节功能委员会评分（International Knee Documentation Committee，IKDC）主观评分以及KT-1000检查，同时进行MRI检查，评估腱骨愈合情况。根据MRI表现将腱骨愈合程度由高向低分为5级，对不同时间点的腱骨愈合程度进行评分。结果：所有患者术后Tegner、Lysholm、IKDC评分随着时间推移逐渐改善，腱骨愈合程度也逐渐增高；腱骨愈合程度的高低与患者临床功能评分有明显相关性。结论：随着时间的推移，自体四股腘绳肌重建ACL术后腱骨愈合程度逐渐提高，临床功能评分逐渐改善，腱骨愈合水平与临床膝关节功能评分之间存在明显相关性。

Evaluating the Tendon Bone Healing by MRI after Anterior Cruciate Ligament Reconstruction

The correlation between tendon bone healing and the clinical functional scores after anterior cruciate ligament (ACL) reconstruction using four stranded hamstring has rarely been reported. The purpose of this study is to determine the correlation between tendon bone healing and clinical functional scores after ACL reconstruction using four stranded hamstring. Method: Thirty patients with ACL reconstruction using four strands hamstring were included in this prospective study in our hospital from April 2013 to April 2014. All the patients were evaluated by Tegner, Lysholm, International Knee Documentation Committee (IKDC) objective score and KT-1000 and received MRI examination in the 3rd, 6th and 12th month after the operation respectively. According to MRI, the healing degree of tendon bone was divided into 5 grades, and the healing degree of the tendon at different time points was also evaluated. Result: The Tegner, Lysholm, IKDC scores of all the patients indicate gradual improvement. The degree of tendon bone healing is gradually increased. And the level of tendon bone healing is significantly correlated with the clinical functional scores. Conclusion: The tendon bone healing degree and clinical functional scores are gradually improved over time after ACL reconstruction. There is a significant correlation between the level of tendon bone healing and clinical functional scores of knee joint after the operation.