同种异体骨-髌腱-骨重建后交叉韧带的手术技巧与中期疗效研究  

Surgical technique and mid-term follow-up study of posterior cruciate ligaments reconstruction with allogeneic patellar tendon under arthroscopy

作　　者：郭林[1] 杨柳[1] 段小军[1] 徐崎[1] 陈加荣[1] 陈光兴[1] 戴刚[1] 

机构地区：[1]第三军医大学西南医院关节外科中心

出　　处：《中华关节外科杂志（电子版）》2009年第2期26-28,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨关节镜下同种异体骨-髌腱-骨(B-PT-B)重建后交叉韧带(PCL)的手术技巧与临床疗效。方法2002年5月～2004年9月对19例PCL损伤的患者在关节镜下利用同种异体髌腱重建PCL,并按照国际膝关节评分委员会(IKDC)、Lysholm和Tegnar膝关节评分标准评价疗效。结果所有患者术后获50～70个月(平均59个月)的随访。术后无伸膝受限,最后随访时屈膝活动度为125°～140°(平均130.5°)。Lysholm膝关节功能评分术前为(67.2±5.9)分,终末随访时为(93.2±5.5)分,手术前后的差异有统计学意义(t=0.021,P<0.01)。Tegnar运动能力评价表在初次受伤前为(5.2±1.2)分;受伤后术前为(2.1±0.5)分;随访结束时为(5.0±1.5)分。受伤前和随访结束时评分间的差异无统计学意义(t=0.93,P>0.01)。终末随访IKDC评分:A级11例(57.9%),B级6例(31.6%),C级2例(10.5%)。结论关节镜下同种异体髌腱重建PCL手术操作精细、创伤小、结果可靠,术后膝关节功能恢复满意。利用B-PT-B重建PCL需要改良技术以使手术更加顺利地完成。Objective To evaluate the clinical effect of posterior cruciate ligament （PCL） recon- struction by using allogeneic patellar tendon under arthroscopy. Methods From May 2002 to September 2004, 19 cases of ruptured PCL were fixated with compressed screws and reconstructed under arthroscopy with allogeneic patellar tendon. The clinical resuhs were evaluated according to IKDC, Lysholm, and Tegner clinical rating scales. Results All patients were followed up for 50 - 70 months （ average 59 months）. At the last follow-up, there was no knee extension limitation and knee flexion was between 125° and 140° with an average of 130.5°. The Lysholm score was （67.2±5.9） before operation and （93.2 ± 5.5 ） at the last follow up, which had statistical significance （ P 〈 0.01 ）. The Tegner activity score decreased from （ 5.2±1.2 ） before injury to （ 5.0±1.5 ） at last follow-up without significant difference （t = 0. 93）. At time of last follow-up, IKDC score was graded as A in 11 cases （57.9%）, B in 6 cases （31.6%）, and C in 2 case （ 10. 5% ）. Conclusions Reconstruction of PCL with allogeneic patellar tendon under the arthroeope has the advantage of minimal invasion, reliable satisfactory outcome. Special surgical technique was needed to undergo this procedure.

关 键 词：膝 关节镜 后交叉韧带 骨重建 

分 类 号：R687.3[医药卫生—骨科学] R687.34[医药卫生—外科学]