关节镜下应用带跟骨异体跟腱一期联合治疗膝关节脱位合并不稳定  

Treatment of Knee Joint Dislocation and Instability with Calcanei Combined Achilles Tendon Allograft under Arthroscopy at One-Stage

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

机构地区：[1]解放军第309医院全军骨科中心,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14期2674-2677,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一期联合重建治疗膝关节脱位合并不稳定的治疗效果。方法:2008年1月至2010年1月,我们于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合并不稳定患者11例,男9例,女2例;年龄17～45岁,平均22.3岁;右膝6例,左膝5例。患者在排除手术禁忌后,分别在关节镜下采用带跟骨异体跟腱一期联合重建后交叉韧带(PCL)、内侧副韧带(MCL)、前交叉韧带(ACL)和外侧副韧带(LCL)。结果:术后所有切口均于2周后I期愈合。10例获得随访,随访时间24～36个月,平均30个月。术后24个月,Lysholm评分由术前的42.2±3.5,升至84.5±6.2分,其中A级9例,B级1例,C级0例;国际膝关节文献委员会(IKDC)评分有术前的41.7±6.5分,升至82.3±10.3分。术前与术后Lysholm评分及IKDC评分有显著差别(P<0.05)。术后膝关节活动范围,与术前相比具有显著性差异(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稳定和活动范围,具有令人满意的临床效果。Objective： To evaluate the effectiveness of dislocated and unstable knee joint reconstruction using calcanei combined achilles tendon allograft under arthroscopy at one-stage.Methods： From January 2008 to January 2010,we treated 11 patients of knee joint dislocation using calcanei combined achilles tendon allograft under arthroscopy at one-stage.There were 9 males and 2 females,aged from 17 to 45 with average age of 22.3.There were 6 patients in right knee and 5 patients in left knee.After surgical contraindications were excluded,all the patients were treated with a calcanei combined achilles tendon allograft.The posterior cruciate ligament（PCL）,medial collateral ligament（MCL）,anterior cruciate ligament（ACL） and lateral collateral ligament（LCL） were reconstructed respectively.Results： All the incisions healed by the first intention two weeks after operation.Ten of the patients were followed up for 24-36 months,average 30 months.The function of the knee joint was measured by Lysholm and IKDC scores.Pre-operation the average Lysholm score of the patients was 42.2±3.5,and 24 months post-operation the score raised to 84.5±6.2.And pre-operation the average IKDC scores of the patients were 41.7±6.5,and 24 months post-operation the score raised to 82.3±10.3.There were significant differences between the scores of pre-operation and post-operation（P0.05）.There were significant differences between the movement ranges of pre-operation and post-operation（P0.05）.Conclusions： The application of calcanei combined achilles tendon allograft for the treatment of dislocated knee joint under arthroscopy at one-stage could recover the stable and movement range of knee joint,showing satisfactory clinical effects.

关 键 词：关节镜 膝关节 关节脱位 同种异体肌腱 带跟骨跟腱 

分 类 号：R684[医药卫生—骨科学]