关节镜下多股自体腘绳肌腱双束双隧道重建膝前交叉韧带

目的：探讨膝关节镜下应用多股腘绳肌腱双束双隧道重建前交叉韧带(anterior cruciate ligament,ACL)的方法及疗效。方法：ACL损伤患者21例，男性13例，女性8例,平均年龄25.4（17～50）岁，全部经膝关节镜最后确诊。并在关节镜下分别于ACL股骨胫骨附着处建立两骨隧道，重建ACL的前内侧束及后外侧束；股骨侧以带袢钢板（Endo-buttons）悬吊固定，胫骨侧以生物型阻滞螺钉固定。结果：术后随访15.8（13～23）月。术前所有患者前抽屉试验均为阳性，Lachman试验19例阳性。术后屈膝90°时前抽屉试验20例阴性，1例阳性；Lachman试验19例阴性，1例弱阳性，1例阳性。Lysholm评分术前36~58分，术后71~95分，术后总优良率95.2%。结论：双隧道多股自体腘绳肌腱重建ACL能更好地有效恢复膝关节动态稳定性，疗效满意。

Arthroscopic double-dundle double-tunnel anterior cruciate ligament reconstruction using multi-strand hamstring autograft

ObjectiveTo explore surgical reconstruction and clinical effect of arthroscopic double-bundle double-tunnel reconstruction of anterior cruciate ligament (ACL ) with multi-strand hamstring tendons autograft.MethodsTwenty-one patients (13 males and 8 females) with ACL deficiency were diagnosed with arthroscopy, with an average age of 25.4 (17～50) years. The 2 separate tibial tunnels and 2 femoral tunnels were drilled on the footprint of the ACL to reconstruct the anteromedial and posterolateral bundles with arthroscopy.Tendons were fixed with Endo-button/polyester tape constructs at the femoral side and with biodegradable interference screw at the tibial side.ResultsAll patients were followed up for 15.8 (13～23) months. The anterior drawer test was positive in all patients and Lachman test was positive in all but 2 preoperatively. The postoperative results of anterior drawer test were negative in all but 1 at 90°of knee flextion. Lachman test was positive in 1, suspiciously positive in 1 and negative in other patients. The Lysholm knee score increased from 36～58 preoperatively to 71～95 postoperatively and the fineness rate was 95.2%.ConclusionArthroscopic double-bundle double-tunnel reconstruction ACL with multi-strand hamstring tendons autograft is effective and reliable to restore the better dynamic stability of the knee.