术中X线透视定位行LARS韧带重建前交叉韧带的临床价值  

Clinical valure of C-arm fluoroscopy in arthroscopic reconstruction of anterior cruciate ligament with LARS artificial ligament

作　　者：徐又佳[1] 沈光思[1] 董启榕[1] 周海斌[1] 徐炜[1] 陈海南[1] 谢宗刚[1] 

机构地区：[1]苏州大学附属第二医院骨科,215004

出　　处：《中华创伤杂志》2011年第2期141-145,共5页Chinese Journal of Trauma

摘　　要：目的探讨在LARS韧带重建前交叉韧带（ACL）手术中，关节镜下运用X线透视定位法的操作特点和临床疗效。方法2006年6月起运用法国LARS韧带治疗急性膝关节ACL断裂36例，男25例，女11例；年龄22～51岁，平均28．3岁。左膝19例，右膝17例。所有患者术前MRI均提示ACL连续信号中断，膝关节Lysholm评分平均52分。操作在关节镜下完成，其中股骨隧道口定位、胫骨隧道口定位主要依靠术中C形臂X线机定位；LARS韧带直径为7．5mm，空心挤压螺钉直径为8．0mm。结果本组患者获9～20个月（平均18个月）随访。36例患者术前Lysholm评分平均为52分；术后12个月平均为92分。本组优23例，良9例，可4例，近期优良率为89％。结论在关节镜下运用X线透视定位法进行LARS人工韧带重建膝ACL，操作方便，定位准确，手术效果优良。Objective To discuss the operation skills and clinical effects of C-arm fluoroscopy in arthroscopic reconstruction of anterior cruciate ligament （ACL） with the Ligament Advancement Reinforcement System （LARS） artificial ligaments. Methods The study involved 36 patients with acute ACL rupture treated with the LARS artificial ligaments from June 2006. There were 25 males and 11 females, at age range of 22-51 years （average 28.3 years） , involving 19 left knees and 17 right knees. The results of preoperative MRI of all patients suggested discontinuation of ACL, with average score of Lysholm on knee joint for 50. The operation was completed under arthroscope. While the locations of the femoral tunnel portal and the tibial tunnel exit were mainly determined by the C-arm fluoroscopy. The diameter of the LARS artificial ligament was 7.5 mm while that of the interference screw 8 mm. Results All 36 patients were followed up for a mean duration of 18 months （9-20 months）. The average Lysholm Score was 52 preoperatively and 92 at the 12th week after operation. The clinical results were graded as excellent in 23 patients, good in nine and fair in four according to the Lysholm＇s classification, with excel- lence rate of 89%. Conclusions Arthroseopic reconstruction of anterior crueiate ligament with LARS artifical ligament under C-arm fluoroscopy takes advantages of convenient operation, accurate location and satisfactory clinical effect.

关 键 词：前交叉韧带 放射外科手术 LARS人工韧带 

分 类 号：R686[医药卫生—骨科学]