关节镜下前交叉韧带单束全内重建的中期临床疗效  

Mid-term clinical results of arthroscopic all-inside single bundle anterior cruciate ligament reconstruction

作　　者：李智尧 喻飞[1] 马立峰[1] 戴益科 尹合勇 张京新 刁乃成[1] 郭艾[1] LI Zhi-yao;YU Fei;MA Li-feng(Department of Orthopedics,Beijing Friendship Hospital(Tongzhou District),Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京友谊医院(通州院区)骨科,北京101149

出　　处：《临床和实验医学杂志》2025年第3期280-284,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金资助项目(编号:7222035)。

摘　　要：目的观察关节镜下前交叉韧带(ACL)单束全内重建的中期临床疗效。方法回顾性分析2018年12月至2022年6月在首都医科大学附属北京友谊医院(通州院区)采用关节镜下单束全内可调袢钢板双悬吊技术治疗的ACL损伤患者68例。所有患者在关节镜下以自体腘绳肌腱全内技术单束重建ACL。术后以X线及CT观察钛钢板位置和隧道情况。术前、末次随访时以轴移试验、Lachman试验和前抽屉试验评价膝关节稳定性,并以Lysholm评分和Tegner评分评价膝关节术后功能。结果所有患者术后获2年以上随访,平均(37.5±2.6)个月。术前麻醉下查体,轴移试验阳性68例,Lachman试验阳性68例,前抽屉试验阳性68例。末次随访时,68例患者术膝轴移试验阴性60例,阳性8例;Lachman征阴性48例,Ⅰ度阳性19例,Ⅱ度阳性1例;前抽屉试验阴性42例,Ⅰ度阳性22例,Ⅱ度阳性4例;各项体征均较术前改善,差异均有统计学意义(P<0.05)。末次随访时Lysholm评分为(83.1±7.9)分,明显高于术前[(43.9±5.6)分],差异有统计学意义(P<0.05)。末次随访时Tegner运动功能评分为(8.4±0.5)分,明显高于术前[(3.1±0.6)分],差异有统计学意义(P<0.05)。末次随访时患者膝关节运动能力明显提高,所有患者Tegner评分都在7分以上,35例患者达到9分,能够参加比较激烈的体育运动。结论采用的单束全内方法重建ACL,是一项可靠的临床技术,手术创伤小,膝关节稳定性好,膝关节功能恢复情况佳,具有较好的中期临床疗效。Objective To evaluate the mid-term clinical outcome of all-inside single bundle reconstruction of anterior cruciate ligament(ACL).Methods A retrospective analysis was performed on 68 patients with ACL injury who were treated with all-inside single-bundle reconstruction with adjustable loop button fixation in Beijing Friendship Hospital(Tongzhou District),Capital Medical University from December 2018 to June 2022.The ACL was reconstructed with autologous hamstring tendon under arthroscopy.The position of the titanium plate and tunnel were observed by X-ray and CT after surgery.The pivot shift test,Lachman test and anterior drawer test were used to evaluate the stability of the knee joint before operation and the last follow-up,and the postoperative function of the knee joint was evaluated by Lysholm score and Tegner score.Results All patients were followed up for more than 2 years,mean(37.5±2.6)months.Preoperative physical examination under anesthesia showed that 68 cases were positive for pivot shift test,68 cases were positive for Lachman test,and 68 cases were positive for anterior drawer test.At the last follow-up,there were 60 negative cases and 8 positive cases in the knee pivot shift test of 68 patients.There were 48 cases of negative Lachman sign,19 cases of positiveⅠdegree and 1 case of positiveⅡdegree.Anterior drawer test was negative in 42 cases,Ⅰdegree positive in 22 cases,Ⅱdegree positive in 4 cases.All the signs were improved compared with those before operation,and the differences were statistically significant(P<0.05).The Lysholm score at the last follow-up was(83.1±7.9)points,which was significantly higher than that before operation[(43.9±5.6)points],and the difference was statistically significant(P<0.05).The Tegner motor function score at the last follow-up was(8.4±0.5)points,which was significantly higher than that before operation[(3.1±0.6)points],and the difference was statistically significant(P<0.05).Conclusion The single-bundle all-inside method used to reconstruct the ACL is

关 键 词：前交叉韧带 关节镜 全内技术 单束重建 中期疗效 

分 类 号：R687.4[医药卫生—骨科学]