关节镜下四股半腱肌腱与股薄肌腱重建前交叉韧带

目的　探讨关节镜下应用四股半腱肌腱与股薄肌腱重建前交叉韧带的方法及疗效。方法　对 2 3例前十字韧带 (ACL )损伤患者行关节镜下四股半腱肌腱与股薄肌腱 ACL重建术 ,均取自同侧 ,将两股肌腱分别对折组成 4股 ,编织后预牵张 ,等长点部位钻胫骨骨道、股骨骨道 ,将肌腱拉入骨道 ,分别在屈膝 90°和伸膝位分别将两肌腱收紧 ,两端可吸收扣栓固定。合并损伤同期处理。结果　术后随访 3月～ 4年 ,平均 2 6月。术后 4周关节活动均达正常范围 ,术后抽屉试验除 4例 I度外 ,余 19例均阴性 ;L ysholm评分 ,术后 72～ 10 0分 ,平均 89分 ,较术前 5 4分明显提高 ;Tegner运动评级术后 4～ 8级 ,平均 6级 ,较术前平均 3级有所提高。结论　关节镜下四股半腱肌腱与股薄肌腱重建前交叉韧带 ,可吸收扣栓固定 ,是治疗 ACL断裂的较好方法。

Reconstruction of anterior cruciate ligament under arthroscope using a quadruple-strand semitendinous and gracilis tendon

Objective To investigate the method and the efficacy of anterior cruciate ligament reconstruction with semitendinosus and gracilis tendon under arthroscope.Methods Twenty-three patients with injury of anterior cruciate ligament(ACL) were operated with ACL reconstruction using a quadruple-strand semitendinosus and gracilis tendon from the homolateral under arthroscope. The two tendons were bended into four boundel . After the four boundel was waved and then performed with prestretch , the tibial and femoral tunnel were performed by drilling at the isometric points , and then the tendors were pulled into the bone tunnels.The two tendors were intensified when genufleding at 90 degree and genuextensing, and fixed with absorbable button. Results All patients were followed-up from three months to four years , mean time was twenty-six months.Articular activity reached the normal range at forth month after the operation , and patients showed I degree and other 19 cases were all negative by the drawer test. Lysholm score was 72～100 (mean 89 ) ,and the Tegner activity scale was average 6 grade(4～8 grades)which was higher than 3 grade , compared to the preoperation. Conclusion It is a good method that reconstruction of ACL for fragementation of anterior cruciate ligament using a quadruple-strand semitendinous and gracilis tendon.