关节镜辅助下修复重建膝关节多韧带损伤  

Treatment of multiple ligament injury of the knee with arthroscopy

作　　者：王邦军[1] 莫树喜[1] 严力军[1] 

机构地区：[1]华中科技大学同济医学院附属襄樊医院骨科,湖北襄樊441021

出　　处：《临床骨科杂志》2010年第5期532-533,共2页Journal of Clinical Orthopaedics

摘　　要：目的探讨关节镜辅助下修复重建膝关节多韧带损伤的手术效果。方法对15例患者在关节镜监控下采用自体肌腱(腓骨长肌腱或健侧肢体半腱肌、股薄肌腱)、同种异体肌腱重建关节内的前、后交叉韧带,关节外的侧副韧带采用带线锚钉原位直接缝合或加强缝合。结果 15例均获得随访,时间10～24个月。按Lysholm功能评分标准:术前为25～42(30.2±3.5)分,末次随访时为75～96(87.0±6.0)分;主动关节活动范围由术前40～100(65.0±12.5)°提高到术后100～140(120.0±15.0)°;术前、术后比较差异有统计学意义(P<0.05)。无感染或血管神经损伤等并发症发生。结论关节镜辅助下联合使用自体和同种异体肌腱修复膝关节前、后交叉韧带损伤,可重建膝关节稳定性,是治疗膝关节多韧带损伤的有效方法。Objective To investigate the reconstruction effects of the multiple ligaments injuries by arthroscopy.Methods 15 cases of the anterior and posterior cruciate ligament injuries were reconstructed using autograft（peroneus longus,semitendinosus and gracilis tendons）and allograft under arthroscopy and the collateral ligaments and other structures of the knee were repaired.Results A follow-up was made in the 15 patients for 10～24 months.The Lysholm scores improved from 25～42（30.2±3.5）preoperatively to 75～96（87.0±6.0）last postoperatively.The movement ranges of the knee were 40～100°（65.0±12.5）° preoperatively and 100～140°（120.0±15.0）° last postoperatively.The were significant difference between preoperative group and postoperative group（P〈0.05）.No infection,nerve or vascular injury was found.Conclusions Reconstruction of anterior and posterior ligament injuries through arthroscopy with autograft or allograft has good clinical effects and can be used as a main method of the reconstruction.

关 键 词：膝损伤 关节镜检查 多韧带损伤 

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