保留残端自体腘绳肌腱重建前交叉韧带  

Arthroscopic single-bundle hamstring tendons for the reconstruction of the anterior cruciate ligament with remnants and remaining bundle preservation

作　　者：程文丹[1] 李品[1] 江淮[1] 邵松[1] 刘兴国[1] 吕建军[1] 许俊胜[1] 

机构地区：[1]安徽医科大学附属六安市人民医院骨科,安徽六安237005

出　　处：《临床骨科杂志》2014年第3期299-301,共3页Journal of Clinical Orthopaedics

摘　　要：目的：探讨保留残端自体绳肌腱重建前交叉韧带（ACL）的临床疗效。方法15例患者经关节镜检查证实为ACL损伤，其中完全断裂12例，部分束支断裂3例。对ACL完全断裂的残端稍作清理后予以保留，部分束支断裂的残留束支予以保留，同时对断裂束支的残端予以保留，采用自体四股绳肌腱单束重建前交叉韧带，股骨端采用Endobutton固定，胫骨端采用界面螺钉固定。结果患者均获得随访，时间9～12个月。患者膝关节稳定性均增强。Lysholm 膝关节功能评分：术前56～76（63±8.11）分，术后86～100（94±6.31）分。Lachman试验阴性12例，弱阳性3例。末次随访时膝关节活动度达120°～160°（140°±3.15°），15例患者均恢复伤前运动水平。结论 ACL重建术中残端的保留有助于重建韧带的再血管化、腱骨愈合及本体感觉的建立，术后膝关节功能恢复满意。Objective To investigate the clinical effects of the arthroscopic single-bundle hamstring tendons for the reconstruction of the anterior cruciate ligament （ACL）with remnants and remaining bundle preservation.Methods 15 patients with ACL rupture were verified with arthroscopy,there were 12 cases of complete disruption,3 cases of partial disruption ACLs.All the damaged ACLs were reconstructed with single bundle of autogenous quadrupled ham-string tendons under arthroscopy with the remnants or the remaining bundle preservation.The femur tunnel was fixed by the Endobutton system,and bioabsorbable interference screw was used to fix the tibia tunnel.Results All of them were followed up ranged from 9 to 12 months.The knee joint stability was recovered after the operation.Ly-sholm score was remarkablely increased from 56-76 （63 ±8.11）to 86-100 （94 ±6.31）after operation.Lachman test was negative in 12 cases and weakly positive in 3 cases.At the end of the follow-up,the range of motion of all the knees was 120°-160°（140°±3.15°）.Pre-injury activity levels were restored in all these cases.Conclusions Arthroscopic reconstruction of ACL with remnants and remaining bundle preservation potentially facilitates revascu-lization,tendon-bone healing and proprioception recovery of the reconstructed ligament.

关 键 词：前交叉韧带损伤 关节镜检查 保留残端 腘绳肌腱 

分 类 号：R686.5[医药卫生—骨科学] R687.2[医药卫生—外科学]