关节镜下GraftLink技术重建联合带线锚钉固定治疗前交叉韧带合并内侧副韧带损伤  

Arthroscopic GraftLink technique reconstruction combined with suture anchor fixation for anterior cruciate ligament and medial collateral ligament injuries

作　　者：吴成[1] 谢国庆[1] 金文孝[1] 任忠明[1] 薛军[1] 杨坤 WU Cheng;XIE Guoqing;JIN Wenxiao;REN Zhongming;XUE Jun;YANG Kun(Department of Joint Surgery,Zhejiang General Team Hospital of Chinese Peopled Armed Police Force,Jiaxing Zhejiang,314000,P.R.China)

机构地区：[1]武警浙江省总队医院关节外科

出　　处：《中国修复重建外科杂志》2019年第6期685-688,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：嘉兴市科技局公益技术应用研究项目(2018AD32177)~~

摘　　要：目的探讨关节镜下GraftLink技术重建前交叉韧带(anterior cruciate ligament,ACL)联合带线锚钉固定修复内侧副韧带(medial collateral ligament,MCL)Ⅲ度损伤的疗效。方法 2015年6月-2018年2月,收治28例ACL断裂合并MCLⅢ度损伤患者。关节镜下采用GraftLink技术以自体腓骨长肌腱(peroneus longus tendon,PLT)重建ACL,带线锚钉固定修复MCL。男22例,女6例;年龄21~47岁,平均30.4岁。受伤原因:交通事故伤18例,高处坠落伤7例,运动损伤3例。受伤至入院时间1~2周,平均1.3周。术前膝关节Lysholm评分为(46.8±3.0)分,国际膝关节文献委员会(IKDC)评分为(49.2±2.7)分。踝关节美国矫形足踝协会(AOFAS)评分为(98.29±0.72)分。Lachman试验及外翻应力试验均为阳性。合并半月板损伤8例,软骨损伤2例。结果手术时间55~90 min,平均72.5 min。术后切口均Ⅰ期愈合,无手术相关并发症发生。患者均获随访,随访时间6~38个月,平均20.7个月。术后3个月膝关节活动度为116~132°,平均122°。Lachman试验2例胫骨前移<5 mm,其余均为阴性;外翻应力试验均为阴性。术后6个月,膝关节Lysholm评分为(90.2±1.8)分、IKDC评分为(93.5±2.3)分,明显高于术前(t=31.60,P=0.00;t=29.91,P=0.01);踝关节AOFAS评分为(97.86±0.68)分,与术前比较差异无统计学意义(t=2.89,P=0.08)。术后6个月,KT-1000测量双侧膝关节前向松弛度差值<2 mm者25例,3~5 mm者3例。结论关节镜下采用GraftLink技术以PLT重建ACL联合带线锚钉固定修复MCL,具有膝关节损伤小、恢复快的优点,且取腱后对踝关节功能无明显影响。Objective To investigate the effectiveness of arthroscopic GraftLink technique reconstruction combined with suture anchor fixation in treatment of anterior cruciate ligament(ACL) rupture and medial collateral ligament(MCL) grade Ⅲ injury. Methods Between June 2015 and February 2018, 28 patients with ACL rupture and MCL grade Ⅲ injury were treated. Arthroscopic GraftLink technique was used to reconstruct ACL with autologous peroneus longus tendon(PLT), and suture anchor fixation was used to repair MCL. There were 22 males and 6 females,aged 21-47 years, with an average age of 30.4 years. The cause of injury included traffic accident in 18 cases, falling from height in7 cases, and sports injury in 3 cases. The time from injury to admission was 1-2 weeks, with an average of 1.3 weeks. The preoperative Lysholm score of knee joint was 46.8±3.0 and the International Knee Documentation Commission(IKDC)score was 49.2±2.7. The American Orthopaedic Foot and Ankle Society(AOFAS) score of ankle joint was 98.29±0.72.Both Lachman test and valgus stress test were positive. There were 8 cases of meniscus injury and 2 cases of cartilage injury. Results The operation time ranged from 55 to 90 minutes, with an average of 72.5 minutes. All incisions healed by first intention after operation, and no complications related to operation occurred. All patients were followed up 6-38 months, with an average of 20.7 months. At 3 months after operation, the range of motion of the knee joint was 116-132°, with an average of 122°. Lachman test showed that the anterior translation more than 5 mm in 2 cases, and the others were negative;while the valgus stress test showed that all patients were positive. At 6 months after operation, the Lysholm score and IKDC score of knee joint were 90.2±1.8 and 93.5±2.3, respectively, which were significantly higher than preoperative scores(t=31.60, P=0.00;t=29.91, P=0.01);AOFAS score of ankle joint was 97.86±0.68, with no significant difference compared with preoperative score(t=2.89, P=0.08). KT-

关 键 词：关节镜 GraftLink技术 前交叉韧带 内侧副韧带 自体肌腱 带线锚钉 

分 类 号：R687.4[医药卫生—骨科学]