关节镜下腘绳肌腱结“瓶颈”式固定重建后交叉韧带的早期疗效  

Arthroscopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique

作　　者：张羽飞[1] 王大正 王福生[1] 王立德[1] 张卫国[1] 

机构地区：[1]大连医科大学附属第一医院骨科,116011 [2]盘锦市第一人民医院

出　　处：《中华创伤骨科杂志》2006年第12期1122-1124,共3页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨关节镜下采用腘绳肌腱结“瓶颈”式固定方法重建后交叉韧带的临床疗效。方法自2002年4月～2005年6月对13例后交叉韧带损伤患者在关节镜下采用多股腘绳肌腱结“瓶颈”式固定方法进行重建,术后随访7个月以上,并通过关节屈伸活动度、后抽屉试验、Lachman试验、Lysholm评分、国际膝关节文献委员会(IKDC)评分进行疗效评定。结果全部病例均获随访,时间7～26个月,平均13．4个月。术后＞6个月时随访,无一例膝关节伸直受限,屈膝＞140°11例,屈膝120°1例,屈膝100°1例。后抽屉试验：Ⅰ度11例,Ⅱ度2例；Lachman,征≤Ⅰ度阳性11例,Ⅱ度2例。Lysholm评分为(90．47±4．13)分,较术前(78．82±2．46)分有明显改善(t=2．416,P=0．029)。IKDC评级：A级6例,B级5例,C级1例。结论采用腘绳肌腱结“瓶颈”式固定方法关节镜下重建后交叉韧带,组织相容性好,损伤小,降低了手术费用,有一定临床应用前景。Objective To evaluate arthroscopic PCL （posterior cruciate ligament） reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique. Methods Thirteen cases with PCL injury were treated with arthroscopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique between April, 2002 to June, 2005. The patients were followed up for at least seven months to evaluate the clinical effects by means of ROM of the joint, post drawer test, Lachman test, Lysholm and IKDC （International Knee Documents Committee） scores. Results The patients were followed up for an average of 13.4 months. No limitation of knee extension was found six months after operation. Eleven patients had normal knee flexion（〉 140°）, one had knee flexion of 120° and one 100°. In posterior drawer test, 11 patients were grade Ⅰ and two grade Ⅱ. In Lachman test, 11 patients were rated as within grade Ⅰ and two grade Ⅱ. By Lysholm knee function scale, the average knee scores were 90. 47 ± 4.13 and 78.82 ± 2.46 respectively before and after operation, and the difference was of statistical significance （ t = 2. 416, P = 0. 029）. By IKDC scale, six were grade A, five grade B and one grade C. Conclusion Arthroscopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique is a reliable method to restore knee function and will have a prospect of wide application because of its good tissue biocompatibility, less invasion, and less operative expenditure.

关 键 词：后交叉韧带 重建术 胭绳肌 瓶颈式固定 

分 类 号：R687.2[医药卫生—骨科学]