关节镜下同种异体跟腱经股骨双束双隧道重建后交叉韧带  

ARTHROSCOPIC DOUBLE-BUNDLE POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING ACHILLES TENDON ALLOGRAFT

作　　者：邵德成[1] 陈百成[1] 高石军[1] 孙然[1] 李晗[1] 闫昌葆[1] 

机构地区：[1]河北医科大学第三医院关节科,石家庄050051

出　　处：《中国修复重建外科杂志》2010年第2期235-238,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨采用同种异体跟腱经股骨双束双隧道重建后交叉韧带的方法及临床疗效。方法2005年9月-2006年9月,应用同种异体跟腱经股骨双束双隧道重建后交叉韧带治疗17例Ⅲ度急性后交叉韧带损伤患者。男12例,女5例;年龄19～48岁,平均31.7岁。左膝10例,右膝7例。致伤原因:运动伤6例,交通伤11例。受伤至手术时间7～30d,平均16d。术前屈膝活动度为(121.8±4.1)°;后抽屉试验均为阳性,侧扳试验均为阴性。Lysholm评分为(50.8±6.1)分,Tegner评分为(1.3±0.7)分。KT-1000测量双侧膝关节前后向松弛度差异为(10.5±1.6)mm。结果患者手术时间(67.8±9.4)min,术后体温超过37.4℃时间为(5.4±1.2)d,住院时间(13.6±2.4)d。术后切口均Ⅰ期愈合,无相关并发症发生。17例均获随访,随访时间18～30个月,平均25个月。末次随访时屈膝活动度为(116.9±3.1)°,与术前比较差异无统计学意义(P>0.05)。后抽屉试验及侧扳试验均为阴性。双膝前后向松弛度差异为(2.7±1.7)mm,Lysholm评分及Tegner评分分别为(91.6±3.2)、(6.0±0.7)分,与术前比较差异均有统计学意义(P<0.05)。结论同种异体跟腱是重建后交叉韧带的良好移植物。双束可分别重建其前外侧束及后内侧束,符合解剖生理结构,可较好地恢复膝关节功能,近期疗效满意。Objective To study the method and clinical results of arthroscopic double-bundle posterior cruciate ligament（PCL）reconstruction using achilles tendon allograft.Methods From September 2005 to September 2006,17 patients with PCL injuries of grade III received arthroscopic double-bundle PCL reconstruction using achilles tendon allograft.There were 12 males and 5 females with an average age of 31.7 years（range,19-48 years）,including 10 cases of left PCL injuries and 7 cases of right PCL injuries.Injury was caused by sports in 6 cases and traffic accident in 11 cases.The average time from injury to surgery was 16 days（range,7-30 days）.The preoperative knee flexion was（121.8±4.1）°.The posterior drawer test was positive and the varus angulation test was negative in all 17 patients.Lysholm score was 50.8±6.1 and Tegner score was 1.3±0.7.The side-to-side difference was（10.5±1.6）mm by KT-1000 arthrometer.Results The hospitalization were（13.6± 2.4）days.The operation time was（67.8±9.4）minutes.The time was（5.4±1.2）days when the body temperature was higher than 37.4℃after operation.All incisions healed by first intention.No complication occurred.All 17 patients were followed up 25 months on average（range,18-30 months）.The knee flexion was（116.9±3.1）°at the final follow-up,showing no significant difference when compared with that of preoperation（P0.05）.The posterior drawer test and the varus angulation test were negative in all 17 patients.Lysholm score and Tegner score were 91.6±3.2 and 6.0±0.7,respectively,and the side-to-side difference was（2.7±1.7）mm,showing significant differences when compared with those of preoperation（P0.05）.Conclusion Achilles tendon allograft is fit for PCL reconstruction.Arthroscopic double-bundle posterior cruciate ligament reconstruction using achilles tendon allograft can reconstruct both anterolateral and posteromedial bundles of the PCL.The knee joint function can be restored effectively.The short-term outcome has been proved,but

关 键 词：后交叉韧带 同种异体跟腱 双束重建 关节镜 

分 类 号：R687.4[医药卫生—骨科学] R686.5[医药卫生—外科学]