全内短腱技术行后交叉韧带双束保残重建术的近期疗效

目的 :探讨关节镜下采用全内短腱技术行后交叉韧带双束保残重建术的方法及疗效。方法 :自2010年10月至2018年6月收治50例单纯后交叉韧带断裂患者,男35例,女15例;年龄20～45岁;急性损伤16例,陈旧损伤34例。取同侧自体腘绳肌腱,关节镜下保留后交叉韧带残端,采用全内短腱技术双束重建后交叉韧带,移植韧带两端利用带可调节袢悬吊钛板固定。采用Lysholm膝关节评分、IKDC评分评价临床疗效。结果:50例均获随访,时间6～60(28.84±9.52)个月,末次随访时,膝关节活动度均恢复至正常范围。Lysholm膝关节评分中位数值术前54分,术后100分。根据IKDC评分,术前A级0例,B级0例,C级20例,D级30例;术后A级29例,B级19例,C级1例,D级1例,差异有统计学意义(P<0.01)。结论:关节镜下全内短腱技术后交叉韧带双束保残重建术安全可靠,移植肌腱需要量少,固定稳定,骨量保留多有利愈合及翻修,近期疗效肯定。

Short-term effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique

Objective: To explore the method and curative effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique.Methods: From October 2010 to June 2018,50 patients with simple posterior cruciate ligament rupture were admitted,including 35 males and 15 females,ranging in age from 20 to 45 years old,16 with acute injury and 34 with old injury. The posterior cruciate ligament(PCL) was reconstructed by double bundle technique with the whole internal short tendon. The two ends of the transplanted ligament were fixed by titanium plate suspended with adjustable loop. The Lysholm knee score and IKDC score were used to evaluate the clinical effects.Results: All the 50 patients were followed up,and the duration ranged from 6 to 60 months,with a mean of(28.84±9.52) months. At the latest follow-up,the knee joint activity returned to normal range. The median value of Lysholm knee score was 54 before operation and 100 after operation. According to the IKDC score,there were 0 case of grade A,0 case of grade B,20 cases of grade C and 30 cases of grade D before operation;29 cases of grade A,19 cases of grade B,1 case of grade C and 1 case of grade D after operation;the difference was statistically significant(P<0.01).Conclusion: Arthroscopic double bundle reconstruction of posterior cruciate ligament with short internal tendon is safe and reliable,with less tendon transplantation,more stable fixation,and more bone reserve,which is beneficial for healing and renovation. The short-term effect is positive.