关节镜下解剖等长重建技术在重建前交叉韧带中的应用  

Application of anatomical isometric technique in arthroscopic reconstruction of anterior cruciate ligament and quadruple hamstring tendon autograft

作　　者：黄长明[1] 沈瑞群[1] 王建雄[1] 范华强[1] 胡喜春[1] 卢海燕[1] 付仰攀[1] 董辉详[1] 

机构地区：[1]解放军第174医院骨科,福建厦门361003

出　　处：《中国矫形外科杂志》2007年第24期1844-1847,共4页Orthopedic Journal of China

摘　　要：[目的]探讨前交叉韧带（ACL）解剖等长重建技术在关节镜下应用的可行性及近期疗效。[方法]对20例前交叉韧带损伤行关节镜下ACL重建木。采用前交叉韧带解剖等长重建技术钻胫骨、股骨骨道。移植物用LARS人工韧带11例，用四股半腱肌股薄肌腱9例。LARS人工韧带用2枚界面螺钉固定韧带，四股半腱肌股薄肌腱股骨端用Endobutton固定、胫骨端用可吸收界面螺钉固定。[结果]手术时间LARS人工韧带组30～80min，平均56min。四股半腱肌股薄肌腱组80—120min，平均100min。20例均随访6～12个月，平均9个月。根据Lysholm膝关节功能评分，LARS人工韧带组术前评分：22—65分（36．72±15．54）分；术后6个月评分：80～98分（90．45±4．68）分（t=10．535，P〈0．01）。四股半腱肌股薄肌腱组：术前评分：20～60分（37．11±12．26）分；术后6个月评分：75～87分（80．44±4．16）分（t=9．615，P〈0．01）。术后6个月LARS人工韧带组与四股半腱肌股薄肌腱组评分在统计学上有显著差异（t=10．569，P〈0．01）。[结论]前交叉韧带解剖等长重建技术在关节镜下重建前交叉韧带术中操作简便，效果可靠，值得推广。LARS人工韧带组近期疗效明显优于四股半腱肌股薄肌腱组。[ Objective]To study the feasibility and short-term effects of the arthroscopic reconstruction of ACL with LARS artificial ligaments and quadruple hamstring tendon autograft usirg anatomical isometric technique. [ Method ] Arthroscopic ACL reconstruction was carried out in 20 patients with ACL injuries by using the LARS artificial ligaments and quadruple hamstring tendon autograft. Bone tunnels of the femur and the tibia were prepared with ACL anatomical isometric technique. 20 patients were divided into LARS artificial ligaments group （11 patients） and quadruple hamstring tendon group（9 patients）. The artificial tendon group was inserted into the tunnels and fixed with two interface screws after being tightened. Quadruple hamstring tendon group was fixed with endobutton plate. [ Result] The operation time were 30 -80 min（ mean,56 min） in LARS artificial ligaments group and 80 -120 min（ mean,100 min） in quadruple hamstring tendon group. No postoperative complications such as synovitis and ligament rupture and movement restriction occurred iF two groups. A follow - up check up was made in the 20 patients for 6 - 12 months（ mean,9 months）. The Lysholm scores improved from a preoperative score of 22 - 65 （ 36.72 - 15.54） to 80 - 98 （90.45 - 4.68） at follow - up （t = 10. 535, P 〈 0. 01 ） in LARS artificial ligaments group, and from a preoperative score of 20 -60（37.11 ±12.26） to 75 -87（80.44-4. 16） at follow-up （t =9. 615,P 〈0. 01） in quadruple hamstring tendon group. There were significant difference in the Lysholm scores between LARS artificial ligaments group and quadruple hamstring tendon group in 6 months follow - up. [ Conclusion ] Anterior erueiate ligament anatomy isometric technique is simple to perform and gives a satisfactory short - term results in arthroscopic reconstruction with LARS artificial ligamentsand quadruple hamstring ten- don. The better results showed in all subseales for the LARS artificial ligaments group during the first 6 months of follow

关 键 词：关节镜 前交叉韧带 人工韧带 膝关节 等长点 

分 类 号：R687[医药卫生—骨科学]