关节镜下部分重建治疗膝关节前交叉韧带不完全断裂  

Selective reconstruction for incomplete injury to anterior cruciate ligament of the knee under arthroscopy

作　　者：张羽飞[1] 王福生[1] 王立德[1] 张卫国[1] 汤欣[1] 

机构地区：[1]大连医科大学附属第一医院骨科,116011

出　　处：《中华创伤骨科杂志》2008年第11期1016-1018,共3页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨前交叉韧带（ACL）不完全断裂的关节镜下诊断及镜下部分重建治疗的疗效和意义。方法2004年6月至2006年12月，经关节镜确诊ACL不完全断裂29例，其中前内侧束断裂21例，后外侧束断裂8例。全部患者于关节镜下重建损伤部分的韧带组织，选用LARS韧带重建11例，自体四股胭绳肌腱移植重建18例，术中完整保留未断裂部分的韧带纤维束。结果全部患者均获随访，平均随访15个月（12～30个月），治疗康复12个月时，门诊进行统一标准膝关节功能评定，膝关节Lysholm评分手术前、后比较差异有统计学意义（P〈0．05）。结论正常ACL的前内侧束和后外侧束各自有不同的功能，对于ACL不完全断裂，准确判断ACL的断裂程度十分重要。有效地重建断裂部分的ACL，能够恢复双束韧带的完整统一，更有益于良好地恢复关节功能，避免晚期并发症的发生，对恢复膝关节稳定和功能有着重要的意义。Objective To explore the clinical skills and effects of arthroscopie diagnosis and selective reconstruction of incomplete anterior cruciate ligament （ACL） injury of the knee. Methods From June 2004 to December 2006, 267 cases of incomplete ACL lesion of the knee were admitted to our hospital and diagnosed under the arthroscopy. Of them, 29 eases （10.9%） were diagnosed as incomplete ACL injury （21 as anterior medial branch （AMB） rupture and 8 as posterior lateral branch （PLB） rupture）. The damaged ligaments were reconstructed selectively under arthroscopy. Eleven cases underwent reconstruction with LARS ligament and 18 with autologous hamstring ligament. The undamaged ligament branches were reserved. Results All cases were followed up for an average period of 15 （12 to 30） months. Rehabilitation lasted 12 months. Statistically significant differences existed between preoperative Lysholm scores and postoperative Lysholm scores （ P 〈 0.05）. Conclusions Selective reconstruction of the damaged ACL parts can keep integrity of double branches of the ligament, improve the joint function and avoid terminal complications. Appropriate treatment and early reconstruction of the damaged ACL under arthroseopy are clinically important for early recovery of the knee stabilization.

关 键 词：前交叉韧带 关节镜 韧带 关节 重建术 

分 类 号：R687.4[医药卫生—骨科学]