关节镜结合有限切开治疗膝关节多韧带损伤

目的：探讨应用关节镜结合有限切开治疗膝关节多韧带损伤的方法和近期疗效。方法：膝关节多韧带损伤患者25例,采用关节镜下异体胫前肌腱重建前后交叉韧带,同时有限切开修复关节周围韧带,处理合并的半月板软骨损伤。术前按照国际膝关节文献委员会（IKDC）综合评价患膝功能均为D级,Lysholm评分平均为（35.0±1.4）分。结果：25例患者术后获24～30个月（平均27.4个月）随访,患膝功能均明显改善。末次随访时IKDC综合评价结果：A级10个（40%）,B级12个（48%）,C级3个（12%）,Lysholm评分平均为（92±1.8）分,与术前相比差异有统计学意义（P〈0.01）。结论：关节镜下同种异体胫前肌腱重建前后交叉韧带结合有限切开修复关节周围韧带,可以明显改善膝关节功能,临床疗效较好。

The Clinical Study on Arthroscope Combined with limited Open Treating Knee Multiple Ligament Injury

Objective:To discuss the treatment methods and short term effect of arthroscope combined with limited open treating knee joint multiple ligament injury.Method:25 cases of ACL and PCL injury were reconstructed with anterior tibial tendon allograft under arthroscope,while repaired the ligaments around the knee and meniscus cartilage through mini-open approach.According to the International Knee Documentation Committee(IKDC) standard,the knee function was class D and Lysholm average score was(35 ± 1.4) before operation.Results:After surgery the 25 patients were followed-up about 24-30 months(average 27.4 months),The knee function of all patients were improved significantly.At termination of follow-up,IKDC score was graded as A in ten cases(40%),B in twelve cases(48%),and C in threee cases(12%).Lysholm average score was(92±1.8).Compared with preoperation,the IKDC and Lysholm score showed significant changes(P<0.01).Conclusion:Reconstruction of ACL and PCL with anterior tibial tendon allograft under Arthroscopy through mini-open approach can significantly improve the knee function The clinical efficacy is better.