关节镜下前交叉韧带重建300例临床研究

目的 探讨关节镜下采用自体半腱肌腱和股薄肌腱重建前交叉韧带(ACL)的短期临床效果.方法 对300例陈旧性ACL断裂患者在关节镜下重建ACL,均采用自体半腱肌腱和股薄肌腱,利用RigidFix /Endobutton和Intrafix/可吸收挤压钉+门形钉系统对移植物进行固定.按照Lysholm和国际膝关节评分委员会(IKDC)膝关节评分标准进行主观评估;按照Lachman试验、PST试验和KNEELAX3检查进行客观评估.结果 所有患者术后获随访10～48个月,平均24个月;Lysholm评分:术前评分平均(50.2±6.4)分,术后最终评分平均(93.3±3.5)分,术前术后对比差异有统计学意义(P<0.01);IKDC评分总体优良率为90.00%;KNEELAX3测量结果:术前差别为5～15 mm,平均(9.85±1.4)mm,术后最终测量为0～5 mm,平均(1.46±1.3)mm,两组差异有统计学意义(P<0.01).结论 关节镜下采用自体半腱肌腱和股薄肌腱重建ACL是一种恢复膝关节稳定性的可靠方法.

Arthroscopic anterior cruciate ligament reconstruction--300 cases clinical research

Objective To detect the short-term clinical effects of arthroscopic anterior cruciate ligament （ACL） reconstruction with multi-strand hamstring autograft. Methods For 300 cases of patients with ACL deficiency arthroscopic reconstruction ACL, using multi-strand hamstring autograft, Tendons were fixed with RigidFix/ Endobutton or Intrafix/biodegradable interference screw. Simultaneous repair of meniscus were performed if needed. Lysholm and IKDC were used as subjective assessment criteria, Lachman test, Pivot shift test, anterior drawer test and KNEELAX3 were used as objective evaluation. Results All patients were followed-up for an average of 24 months （ 10 to 48 months）. The pre-and post-operation Lysholm score of knee were 50. 2±6.4 and 93.3 ±3.5 respectively. Fine/excellent rate of IKDC was 90. 00%, compared with the preoperative difference was statistical,ly significant（ P 〈 O. OI ）. KNEELAX3 measuring results ： preoperative difference for 5-15 mm, average （ 9. 85 ± 1.4） mm, postoperative final measurement for 0-5 ram, average （ 1.46 ± 1.3 ） mm, the two groups had statistically significant difference （ P 〈 0. 01 ）. Conclusions ACL reconstruction with multi-strand hamstring autograft is a reliable technology to recover knee stability.