关节镜下自体同侧腓骨长肌腱重建膝关节前交叉韧带  

Arthroscopic reconstruction of anterior cruciate ligament with autologous ipsilateral peroneus longus tendon

作　　者：余浩[1] 邓晚秋 桑鹏[1] 刘毅[1] YU Hao;DENG Wanqiu;SANG Peng;LIU Yi(Department of Joint Surgery,Affiliated Hospital of Zunyi Medical College,Zunyi Guizhou,563003,P.R.China)

机构地区：[1]遵义医学院附属医院关节外科,贵州遵义563003

出　　处：《中国修复重建外科杂志》2020年第7期843-847,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨采用关节镜下自体同侧腓骨长肌腱(peroneus longus tendon,PLT)重建前交叉韧带(anterior cruciate ligament,ACL)的疗效。方法回顾分析2017年10月—2018年10月采用关节镜下自体同侧PLT重建治疗的35例ACL断裂患者临床资料。男19例,女16例;年龄18~60岁,平均43.4岁。左膝20例,右膝15例。致伤原因:交通事故伤14例,摔伤13例,运动损伤8例。受伤至手术时间3~9 d,平均4.7 d。患者术前膝关节肿胀、疼痛伴活动受限。入院检查前抽屉试验、Lachman试验、轴移试验均为阳性;MRI检查确诊为ACL断裂。术后每3个月随访1次,直至膝关节功能恢复正常。通过MRI和X线片检查观察腱骨愈合情况与Endobutton钢板和空心钉位置,并进行前抽屉试验、Lachman试验、轴移试验观察膝关节活动度恢复情况。采用国际膝关节文献委员会(IKDC)评分、Lysholm评分、膝关节损伤和骨关节炎(KOOS)评分评价患者关节功能改善情况。结果35例患者均获随访,随访时间12~18个月,平均14.2个月。术后患者切口均Ⅰ期愈合,无感染、关节僵硬和再断裂等并发症发生。术后前抽屉试验、Lachman试验、轴移试验均为阴性。MRI示ACL连续,股骨远端隧道和胫骨近端隧道腱骨愈合良好;X线片示Endobutton钢板和空心钉位置稳定。术后3、6、12个月IKDC评分、Lysholm评分及KOOS评分均较术前显著改善,术后随时间延长,各评分均进一步改善,差异均有统计学意义(P<0.05)。结论关节镜下自体同侧PLT重建ACL断裂后患者恢复快,关节功能良好且稳定性强,临床疗效满意。Objective To investigate the effectiveness of anterior cruciate ligament(ACL)reconstruction with the autologous ipsilateral peroneus longus tendon(PLT)under arthroscopy.Methods A retrospective study was conducted on 35 patients with ACL rupture who underwent ACL reconstruction with autologous ipsilateral PLT under arthroscopy between October 2017 and October 2018.There were 19 males and 16 females with an average age of 43.4 years(range,18-60 years),with 20 cases of left knee and 15 cases of right knee.The causes of injury included traffic accident in 14 cases,falling injury in 13 cases,and sports injury in 8 cases.The time from injury to operation ranged from 3 to 9 days(mean,4.7 days).The patients suffered from swelling,pain,and limited mobility of knee joint before operation.The anterior drawer test,Lachman test,and pivot-shift test were positive before operation,whereas MRI was taken to confirm the ACL rupture.After operation,the patients were followed up every 3 months until the knee joint’s function returned to normal.MRI and X-ray films were used to observe the tendon-bone healing as well as the position of Endobutton suspension plate and hollow nail.The anterior drawer test,Lachman test,and pivot-shift test were conducted to observe the improvement of knee joint mobility.The functional improvements were evaluated by the International Knee Documents Committee(IKDC)score,Lysholm score,knee injury and osteoarthritis(KOOS)score.Results All the35 patients were followed up 12-18 months,with an average of 14.2 months.The incisions healed by first intention,and no complications such as infection,joint stiffness,and rerupture occurred.Postoperative anterior drawer test,Lachman test,and pivot-shift test turned to be negative of all patients.MRI showed that the ACL was continuous,and the tendon-bone in the distal femur tunnel and proximal tibia tunnel recovered well after operation.X-ray films showed that the positions of Endobutton suspension plate and hollow nail were stable.The IKDC,Lysholm,and KOOS scores at 3

关 键 词：腓骨长肌腱 关节镜 前交叉韧带 韧带重建 

分 类 号：R687.4[医药卫生—骨科学]