关节镜下横穿钉固定重建膝关节前交叉韧带的临床疗效分析

[目的]观察关节镜下股骨侧应用横穿钉(Transfix)固定,胫骨侧界面螺钉(Interference)结合门型钉固定自体腘绳肌腱或同种异体肌腱重建膝关节前交叉韧带的临床疗效。[方法]膝关节前交叉韧带重建患者117例,所有患者均应用股骨侧横穿钉(Transfix)固定,胫骨侧界面螺钉(Interference)结合门型钉固定行前交叉韧带单束重建,其中使用自体腘绳肌腱患者81例,使用同种异体肌腱患者36例,观察此固定方法的可靠性及近期疗效,使用Lysholm评分及IKDC 2000评价手术前后膝关节功能。[结果]103例患者获得随访,随访时间12～26个月(平均18个月),关节活动度正常。平均Lysholm评分由术前的(57.60±5.74)分提高到术后的(94.55±2.38)分(P0.05)。IKDC 2000评分96例正常,6例(5.8%)接近正常,1例(1%)异常。自体腘绳肌腱组和同种异体肌腱组患者的物理检查及功能评分无明显差异。[结论]股骨侧横穿钉固定,胫骨侧界面螺钉结合门型钉固定重建膝关节前交叉韧带的手术方式近期疗效肯定,移植物固定可靠,手术操作安全。应用自体及同种异体肌腱进行重建都具有良好的临床效果,可根据患者的病情及主观要求进行选择。

Curative effects analysis on arthroscopic anterior cruciate ligament reconstruction with autogenous hamstring or allograft tendon using cross-pin(Transfix)fixation

[Objective]To observe the curative effects on arthroscopic anterior cruciate ligament(ACL) reconstruction with autogenous hamstring or allograft tendon using Transfix at the femoral side,Interference Screw and Spiked Ligament Staple at the tibial side.[Method]The technique of TransFix fixation was used for reconstructing ACL in 117 cases,including 81 cases with autogenous hamstring and 36 cases with allograft tendon.Pre-and post-operative knee joint function and stability as well as X-ray photograph were evaluated according to the Lysholm scoring scale system.The reliability of the fixation and its short-term effect were analyzed.[Result]Totally 103 cases were followed,the follow-up duration ranged from 12 to 26 months(average,18 months).Lysholm score were 57.60±5.74 and 94.55±2.38,respectively before operation and at the time of follow-up(P<0.05).Both groups obtained significant improvement of knee stability after operation,with no significant differences between the two groups.[Conclusion]Using Transfix for ACL reconstruction under arthroscopy is a safe technique and its clinical outcome has been assured.The autogenous hamstring and allograft tendon have the same clinical therapeutic effects in ACL reconstruction.The graft can be selected according to the traumatic condition and the requirements of patients.