远前侧入路在关节镜下前交叉韧带解剖单束重建术中的临床应用  

Clinical application of distal anteromedial portal approach to anatomical single bundle reconstruction of anterior cruciate ligament in arthroscopic surgery

作　　者：谢洋[1] 李苏皖[1] 付国建[1] 李光政 张国桥[1] XIE Yang;LI Suwan;FU Guojian;LI Guangzheng;ZHANG Guoqiao(Department of Orthopaedics,People′s Hospital of Ma′anshan City,Ma′anshan 243000,China)

机构地区：[1]马鞍山市人民医院骨科,安徽马鞍山243000

出　　处：《皖南医学院学报》2019年第1期50-52,共3页Journal of Wannan Medical College

基　　金：马鞍山市卫生计生委第十一批科教专项资金项目(2016KJ15)

摘　　要：目的:评估远前侧入路在关节镜下前交叉韧带解剖单束重建术中的临床应用效果。方法:收集前交叉韧带断裂患者共21例,均采用关节镜下经远前侧入路前交叉韧带解剖单束重建术。术后复查MRI评估股骨隧道的开口位置、隧道的长度及角度、移植物的角度;术后12月行Lachman试验及轴移试验检查,评估膝关节稳定性;对比术前、术后12月膝关节功能。结果:经过12～24月的随访,平均(18.6±2.3)月,所有患者均获得了正常的膝关节活动度,术后复查MRI提示所有患者股骨隧道的开口位置、隧道的长度及角度、移植物的角度良好;术后12月Lachman试验阴性16例,阴性率76.2%;轴移试验阴性18例,阴性率85.7%。所有患者术前膝关节Lysholm评分为43.14±2.08,术后12月为84.57±3.12,术前膝关节IKDC评分为45.14±1.90,术后12月为85.62±3.12,术后评分均高于术前(P<0.05)。结论:经远前侧入路行前交叉韧带解剖单束重建术可以获得较为满意的股骨隧道的开口位置、骨隧道的角度及长度、移植物的角度,术后患者的膝关节功能得到较好的提高。Objective: To evaluate the clinical efficacy of applying distal anteromedial portal approach to anatomic single bundle anterior cruciate ligament reconstruction in arthroscopic surgery. Methods :Twenty-one patients with anterior cruciate ligament rupture were included,and undergone arthroscopic reconstruction of the anterior cruciate ligament by distal anteromedial portal technique.Postoperative MRI was performed to assess the position of the femoral tunnel entrance,the length and angle of the tunnel as well as the graft angle.The Lachman test and the axis shift test were used to evaluate the stability of the knee joint 12 months after surgery.Preoperative knee joint function was compared with that 12 months following operation. Results :Follow-up in 12 to 24 months [mean:(18.6±2.3) months] showed that all patients had normal knee mobility.Postoperative MRI indicated better femoral tunnel access,tunnel length and angle as well as graft angle.Lachman test and axial shift test in 12 months after surgery showed negative findings in 16 cases(76.2%) and in 18 cases(85.7%),respectively.Knee Lysholm score was (43.14±2.08) before operation,and (84.57±3.12) after surgery for all patients.Preoperative scoring by International Knee Documentation Committee (IKDC) was (45.14±1.90),and (85.62±3.12) following surgery.The difference was significant( P< 0.05). Conclusion :The anatomic single bundle anterior cruciate ligament reconstruction via distal anteromedial portal approach can lead to satisfactory femoral tunnel position,angle and length of bone tunnel as well as graft angle,and better improve the patient′s knee joint function after operation.

关 键 词：关节镜 入路 前交叉韧带 重建术 

分 类 号：R687.4[医药卫生—骨科学]