关节镜下保留残端自体胭绳肌重建前交叉韧带的临床研究  

Arthroscopic reconstruction of antertor cruciate ligament with the Hamstring Tendon autograft

作　　者：杨光[1] 陈文栋[2] 文会龙[1] 夏铭阳[1] 胡辉东[1] 

机构地区：[1]苏州大学附属常州市肿瘤医院骨科,江苏常州213001 [2]昆明医科大学第一附属医院骨科,云南昆明650032

出　　处：《常州实用医学》2014年第1期7-9,共3页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的探讨保留残余柬支以及断端纤维进行前交叉韧带重建的方法及意义。方法关节镜下证实前交叉韧带损伤62例，其中部分束支断裂18例，完全断裂38例，韧带松弛6例。对前交叉韧带部分损伤的束支或韧带松弛者予以保留，对完全断裂的残端不做清理，采用自体胭绳肌腱单束重建前交叉韧带，股骨端采用RigidFix固定，胫骨端采用IntraFix固定。结果62例患者全部获得随访，术后随访4～24个月，平均12．4个月。Lysholm膝关节功能评分：术前47—61（53．2±6．0）分，末次随访91—98（94．7±3．7）分，提高41．5±2．3分；Lachman试验阴性59例，弱阳性3例。结论保留残端重建前交叉韧带有助于移植肌腱再血管化、爬行替代和本体感觉建立，有利于维持膝关节稳定性。Objective To investigate the technique and significance of arthroscopic anterior cruciate ligament（ACL）reconstruction with the remaining bundle and ruptured fiber. Methods In 62 cases of ACL rupture verified with arthroscopy, there were 18 cases of partial disruption, 38 cases of complete disruption, and 6 cases of ligament flabby. ACLs were reconstructed with single bundle of autogenous hamstring tendons under arthroseopy without remove of the remaining bundle or remnants of ACL. The femur tunnel was fixed by the RigidFix system, and the Intraflx system was used to fix the tibia tunnel. Results 62 cases were followed up for 4 - 24 months, Lysholm knee function score increased by（41.5 ± 2.3） scores, from 47 - 61（53.2 ± 6.0） scores of pre operation to average 91 - 98 （94.7 ± 3.7） scores after operation. Lachman test was negative in 59 cases, weakly positive in 3 cases.Conclusion To keep the remaining of ruptured fiber for ACL reconstruction is beneficial for the graft revascularization or healing, and is helpful for the position sense or rehabilitation.

关 键 词：自体胭绳肌腱 残端 前交叉韧带 重建 

分 类 号：R685[医药卫生—骨科学]