关节镜下应用带跟骨异体跟腱联合重建前交叉韧带及内侧副韧带  

Reconstruction of Both Anterior Cruciate Ligament and Medial Collateral Ligament Using Calcanei Combined Achilles Tendon Allograft under Arthroscopy

作　　者：冯会成[1] 黄迅悟[1] 孙继桐[1] 常青[1] 毕龙[2] 余方圆[1] 

机构地区：[1]中国人民解放军第309医院骨科,北京100091 [2]第四军医大学西京医院全军骨科研究所,陕西西安710032

出　　处：《现代生物医学进展》2013年第13期2472-2475,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30901532)

摘　　要：目的：探讨关节镜下应用带跟骨异体跟腱联合重建前交叉韧带（anterior cruciate ligament,ACL）及内侧副韧带（medial colateral ligament,MCL）和恢复膝关节前内侧稳定性的效果。方法：选择2007年1月至2010年1月收治符合纳入标准的27例A CL合并MCL损伤患者。其中男18例,女9例;年龄16～48岁,平均32.5岁;右膝15例,左膝12例。患者在排除手术禁忌后,均在关节镜下采用带跟骨异体跟腱一期联合重建ACL和MCL。患者受伤至手术时间7~14天,平均10天。结果：术后2周所有患者切口均I期愈合。所有病例获得长期随访,随访时间24～32个月,平均26个月。术后24个月,Lysholm评分由术前的32.10±4.35升至86.25±4.12分,国际膝关节文献委员会（IKDC）评分由术前的33.27±4.25分,升至82.46±4.13分,术前与术后Lysholm评分及I KDC评分均有显著差别（P〈0.05）。结论：关节镜下应用带跟骨异体跟腱一期联合重建治疗膝关节脱位能够较好的恢复患者膝关节前内侧稳定行,近期效果良好。Objective： To evaluate the effectiveness of calcanei combined achilles tendon allograftunder arthroscopy for the treatment of antero-medical rotary caused by the injuries of bothanterior cruciate ligament（ACL） and medial collateral ligament（MCL）.Methods： From January 2007 to January 2010,27 patients with ACL combined MCL injuries in accordance with the inclusion criteria were treated.They were 18 male and 9 female,aged from 16 to 48 with average age of 32.5.Fifteen of them were injured in right knee and twelve injured in left knee.After surgical contraindications were excluded,all the patients were treated with calcanei combined achilles tendon allograft for the reconstruction of both ACL and MCL.The interval between injury and surgery was 7 to 14 days and the average interval was 10 days.Results： All the incisions healed by the first intention two weeks after operation.Ten of the patients were followed up 24 to 32 months,mean 26 months.Twenty-four months after operation,the function of the knee joint was measured by Lysholm and IKDC（International Knee Documentation Committee） scores.The average Lysholm score were raised from 32.10±4.35（pre-operation） to 86.25±4.12（post-operation）.And the average IKDC scores of the patients were raised from 33.27±4.25（pre-operation） to 82.46±4.13（post-operation）.There were significant differences between the two scores of pre-operation and post-operation（P0.05）.Conclusion： The application of calcanei combined achilles tendon allograft for the treatment of antero-medical rotary caused by the injuries of both ACL and MCLunder arthroscopy at one-stage could recover the stability of knee joint,showing satisfactory clinical effects.

关 键 词：关节镜 前交叉韧带 内侧副韧带 同种异体肌腱 带跟骨跟腱 

分 类 号：R681[医药卫生—骨科学]