关节镜下全内技术半腱肌重建前交叉韧带的近期临床随访观察  

Short-term clinical follow-up of anterior cruciate ligament reconstruction with semitendinosus autograft using arthroscopic all-inside technique

作　　者：尹合勇 郭艾[1] 马立峰[1] 刁乃成[1] 李智尧 杨金江[1] 杨波[1] 喻飞[1] YIN He-yong;GUO Ai;MA Li-feng(Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2022年第11期1185-1188,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金青年项目(编号:82002285)。

摘　　要：目的探讨关节镜下全内技术半腱肌重建前交叉韧带(ACL)的近期临床效果。方法回顾性分析2018年6月至2019年12月期间收治于首都医科大学附属北京友谊医院骨科,接受关节镜下全内技术,以自体半腱肌作为移植物,股骨和胫骨端可调节袢钢板双悬吊固定方式重建ACL的患者27例。通过随访术后相关并发症、Lysholm评分、国际膝关节文献委员会(IKDC)主观膝关节评分、Lachman试验、轴移试验等评估手术的临床疗效。结果27例患者均成功完成手术,并获12~24个月随访,平均随访17.7个月。所有患者末次随访时均未出现感染、韧带再断裂等并发症。Lysholm评分和IKDC评分分别由术前的(55.93±14.47)分和(52.49±13.37)分恢复至末次随访的(88.63±5.37)分和(86.25±5.41)分,差异均有统计学意义(P<0.05)。Lachman试验术前均为阳性(Ⅱ度2例,Ⅲ度25例),末次随访时仅1例阳性(Ⅰ度),差异有统计学意义(P<0.05)。轴移试验末次随访时阳性2例(Ⅰ级),显著少于术前的27例(Ⅰ级2例,Ⅱ级15例,Ⅲ级10例),差异有统计学意义(P<0.05)。结论关节镜下全内技术半腱肌重建前交叉韧带可获得满意的近期临床疗效,显著改善患者膝关节功能和稳定性。Objective To investigate the short-term clinical outcomes of anterior cruciate ligament(ACL)reconstruction with semitendinosus autograft using arthroscopic all-inside technique.Methods A retrospective analysis was performed on 27 patients with ACL rupture and admitted to the Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University from June 2018 to December 2019.The autologous semitendinosus was used as the graft,and the all-inside technique under arthroscopy was used to reconstruct ruptured ACL with double suspensory fixation.The clinical outcomes of the surgery were evaluated by follow-up of postoperative complications,Lysholm score,International Knee Documentation Committee(IKDC)subjective knee score,Lachman test,and pivot shift test.Results All 27 patients were successfully finished the operation and were followed up for 12-24 months,with an average of 17.7 months.There were no complications such as infection and ligament re-rupture at the last follow-up.Lysholm score and IKDC score recovered from preoperative(55.93±14.47)points and(52.49±13.37)points to(88.63±5.37)points and(86.25±5.41)points at last follow-up,respectively,and the differences were statistically significant(P<0.05).The Lachman tests were all positive before operation(2 cases of grade Ⅱ and 25 cases of grade Ⅲ),and only 1 case was positive(grade Ⅰ)at the last follow-up,and the difference was statistically significant(P<0.05).The pivot-shift test was positive in 2 cases(grade Ⅰ)at the last follow-up,which was significantly less than the 27 cases before surgery(2 cases in grade Ⅰ,15 cases in grade Ⅱ,and 10 cases in grade Ⅲ),and the difference was statistically significant(P<0.05).Conclusion Arthroscopic all-inside anterior ACL reconstruction with double suspensory fixation and semitendinosus can achieve satisfactory short-term clinical outcomes with significantly improved knee function and stability.

关 键 词：前交叉韧带 半肌腱重建 关节镜 全内技术 临床随访 

分 类 号：R687.4[医药卫生—骨科学]