关节镜下自体肌腱保残重建前交叉韧带  

Autogenous tendon is protected under arthroscopy remnants of anterior cruciate ligament reconstruction

作　　者：钱春生[1,2] 付昌马[1,2] 

机构地区：[1]合肥市第三人民医院 [2]安徽医科大学合肥第三临床学院骨科,安徽合肥230022

出　　处：《颈腰痛杂志》2015年第2期133-137,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：合肥市科技局重点科研项目(编号:2012 121)

摘　　要：目的研究保留胫骨残端自体腘绳肌腱移植重建前交叉韧带(Anterior Cruciate Ligament ACL)的临床效果和方法。方法收集2011-08-2014-05在安徽医科大学合肥第三临床医院关节镜手术治疗的20例前交叉韧带完全断裂患者。入选全部患者术前查体及磁共振检测显示前交叉韧带完全断裂。将手术前后Lysholm评分、Tegner运动评分、前抽屉试验、Lachman试验进行统计学比较。Lysholm评分、Tegner运动评分两样本t检验;前抽屉试验、Lachman试验采用秩和检验。结果术后Lysholm评分均分(88.3±4.4),与术前比较,统计学具有意义(P<0.05)。术后Tegner评分均分(3.8±1.1),与术前比较,统计学具有意义(P<0.05)。术后前抽屉试验阴性16例,Ⅰ度阳性3例;Ⅱ度阳性1例,与术前相比,统计学具有意义(P<0.05)。术后Lachman试验阴性17例,Ⅰ度阳性3例。与术前相比,统计学具有意义(P<0.05)。结论保留胫骨残端自体腘绳肌腱移植重建前交叉韧带可获得满意的临床治疗效果,其方法简单,操作简便。提示我们在临床应广泛推广保留残端技术重建ACL,以利于患者康复。Objective To study the clinical effect of reserved tibial residual autograft ham- string tendon grafts for anterior cruciate ligament reconstruction （anterior cruciate ligament ACL）. Methods From 2011-08 to 2014-05,20 patients with anterior cruciate ligament rupture in the Third People＇s Hospital of Hefei who received arthroscopic surgery were collected. In all patients, preoperative examination and MRI examination showed anterior cruciate ligament rupture com- pletely. The Lysholm score before and after operation, Tegner sports scores, drawer before test, Lachman test were compared. Lysholm score and Tegner movement score were analyzed by two sample t test;Drawer test and Lachman test were analyzed by rank test. Results Postoperative Lysholm score was （88.3 ±4.4）,compared with preoperation, the difference was statistically signif- icant（P〈0.05）. Postoperative Tegner score was（3.8 ± 1.1）,compared with preoperation, the differ- ence was statistically significant （P〈0.05）. After operation, 16 cases were negative in anterior drawer test,positive I degree in 3 cases, positive Ⅱ degree in 1 case, compared with preopera- tion,the difference was statistically significant （P〈0.05）. Lachman test was negative in 17 cases postoperatively, I degrees positive in 3 cases, compared with preoperation,the difference was sta- tistically significant （P〈0.05）. Conclusion Keep the tibia residual autograft hamstring tendon grafts for anterior crueiate ligament reconstruction can obtain satisfactory clinical effect,the method is simple,easy to operate. Suggest we should be widely popularized in clinical preservation stump technology in ACL reconstruction,to help patients recover.

关 键 词：关节镜 前交叉韧带 移植 重建 膝关节 

分 类 号：R686[医药卫生—骨科学]