关节镜射频皱缩术治疗膝关节交叉韧带松弛(初步报告)  

Tightening Elongated ACL and PCL by Application of Bipolar Radio Frequency under Arthroscopy

作　　者：刘玉杰[1] 蔡胥[1] 王志刚[1] 李众力[1] 王岩[1] 张文涛[1] 

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中国运动医学杂志》2004年第5期529-531,共3页Chinese Journal of Sports Medicine

摘　　要：目的 :探讨关节镜监视下射频皱缩治疗交叉韧带松弛的方法与疗效。方法 :2 0 0 1年 7月～ 2 0 0 3年 9月对关节镜检查发现交叉韧带松弛但其结构连续性存在的 2 2例患者 ,采用关节镜监视下等离子刀皱缩术治疗。其中ACL松弛 14例、PCL 4例 ;ACL重建术后松弛 4例。男 18例 ,女 4例 ;右膝 15 ,左膝 7例。平均年龄 2 8岁 (19～ 36岁 )。膝关节运动伤 9例 ,交通事故伤 7例 ,生活中扭伤 6例。伤后直到手术的时间平均 6个月 (3～ 14个月 )。术后卡盘支具保护下进行功能练习 ,12周解除保护。结果 :术后随访 2 0例 ,失访 2例 ,平均随访 6个月 (4～ 2 2个月 ) ,疗效评估采用Lysholm评分 ,术前平均 35 9分 ,术后平均 88 5分。优 12例 ,良 4例 ,可 2例 ,差 2例。优良率80 %。术后Lachman征由阳性变为阴性 18例 ,患者自觉膝关节稳定 ,功能显著改善。疗效差的 2例行ACL绳肌腱重建。结论 :对ACL和PCL伤后松弛但连续性存在的病例 ,选用射频皱缩术可免除部分患者行交叉韧带重建或翻修手术。Objective To evaluate the clinical effectiveness of bipolar radio frequency tightening elongated ACL and PCL under arthroscopy.Methods From July 2001 to September 2003, twenty-two patients (average age 28, 19～36 years old; 18 males and 4 females; 15 right knees and 7 left; 9 from sports injury, 7 from traffic accident and 6 by sprain injury) with symptomatic laxity and confirmed elongation with rupture of structure were operated with bipolar radio frequency thermal shrinkage under arthroscopy. The average duration till operation was 6 months from injure. After operation, the patients started functional rehabilitation with protection of unlimited knee orthosis for 12 weeks. Results Twenty cases were follow-up for 4 to 22 months with average of 6 months. Lysholm score from 35.9 preoperation increased to 88.5 postoperation. Most patients had significant improvement in stability and function of knee join(excellent in 12,good in 4 and fair in 2). Conclusion Bipolar radio frequency could be applied to tighten elongated cruciate ligament of continuous structure and avoid potential revision and reconstruction in some cases.

关 键 词：治疗 交叉韧带 关节镜 膝关节 术后 患者 射频 皱缩 松弛 选用 

分 类 号：R687[医药卫生—骨科学]