自体肌腱移植修复前交叉韧带合并后外侧角损伤  

Repair of combined anterior cruciate ligament and posterolateral corner injury by tendon autograft

作　　者：张建林[1] 栾彦军[1] 郭龙[1] 行军[1] 白立榜[1] 姜鹏菲[1] 

机构地区：[1]延安大学附属医院骨一科,陕西省延安市716000

出　　处：《中国组织工程研究与临床康复》2011年第53期10060-10063,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：延安市科学技术研究发展基金项目;课题名称:膝关节前交叉韧带并后外侧角损伤的临床研究~~

摘　　要：背景：自体半腱和股薄肌腱移植均可重建交叉韧带和膝关节后外侧角.目的：分析自体半腱和股薄肌腱移植修复膝关节前交叉韧带合并后外侧角损伤的效果.方法：将20例膝关节前交叉韧带合并后外侧角损伤患者随机分成两组：实验组在关节镜辅助下应用自体半腱肌、股薄肌一期重建前交叉韧带和加强重建后外侧角韧带;对照组仅采用自体组半腱肌、股薄肌一期重建前交叉韧带.结果与结论：两组术后Lysom评分较术前明显改善（P 〈 0.01）.实验组患者在站立、行走和上下楼梯时无与膝关节后外侧不稳相关的过伸位膝关节不稳感,未发现行走时膝关节内甩;关节活动度屈曲100°～135°,伸直0°～10°.对照组中3例在站立,行走和上下楼梯时无与膝关节后外侧不稳相关的过伸位膝关节不稳感,4例行走时出现轻微膝关节内甩;关节活动度屈曲104°～130°,伸直0°～10°.说明用自体肌腱移植重建膝关节前交叉韧带和后外侧结构损伤,能够恢复膝关节后外侧与前后方的稳定性,较单纯重建前交叉韧带效果好.BACKGROUND： Cruciate ligament and posterolateral corner of the knee can both be reconstructed by semitendinosus and gracilis tendon autograft. OBJECTIVE： To analyse the repairing effects of semitendinosus and gracilis tendon autograft on knee joint combined anterior cruciate ligament and posterolateral corner injury. METHODS： A total of 20 patients of knee joint combined anterior cruciate ligament and posterolateral corner injury were randomly assigned into experiment group and control group. With the aid of arthroscope, one-stage reconstruction of anterior cruciate ligament was performed by semitendinosus autograft and gracilis tendon autograft, and the reconstructed posterolateral corner was strengthened in the experiment group. Patients in control group only underwent one-stage reconstruction of anterior cruciate ligament. RESULTS AND CONCLUSION： Compared with preoperation, there was a significant improvement in Lysom scores of the two groups （P 〈 0.01）. Experimental patients did not show over-extending knee instability related to unstable posterolateral structures of the knee joint when standing, walking, going upstairs and downstairs. There was no inward swing of the knee joint during walking. The ranges of motion were from 100° to 135° of flexion and from 0° to 10° of extension. There were 3 cases in the control group showed no over-extending knee instability related to unstable posterolateral structures of the knee joint when standing, walking, going upstairs and downstairs, and 4 cases showed slight inward swing of the knee joint during walking. The ranges of motion were from 104° to 130° of flexion and from 0° to 10° of extension. These findings demonstrate that the posterolateral, front and rear stability of the knee joint is recovered after the reconstruction of nterior cruciate ligament and posterolateral corner by tendon autograft. The treatment effect is better than the reconstruction of anterior cruciate ligament alone.

关 键 词：膝关节 后外侧角 前交叉韧带 半腱肌 股薄肌 

分 类 号：R617[医药卫生—外科学]