应用异体跟腱重建前十字韧带和内侧副韧带

目的　探索应用同种异体跟腱在重建前十字韧带 (ACL)的同时 ,重建受损的内侧副韧带 (MCL)的新方法 ,避免由自体取材造成的再损伤及由此引起的并发症。方法　首先在关节镜下应用经深低温冷冻处理的同种异体跟腱 ,采用等长重建、生物固定的方法 ,重建受损的ACL。然后在辅助切口下同时重建受损的MCL。结果　 9例患者应用同种异体跟腱重建ACL和MCL ,全部病例获得了随访 ,采用Lysholm评分法评估患者手术前后的功能 ,术前平均 4 3 2分 ,术后平均 79 8分 ,优良率77 8%。客观检查 :前抽屉试验术前 9例阳性 ,术后均阴性 ;Lachman征术前 9例阳性 ,术后 1例弱阳性。膝外翻实验术前 9例阳性 ,术后均阴性。术后遗留膝关节疼痛 2例 ;膝关节活动受限 3例。结论　应用同种异体跟腱重建ACL ,可同时重建MCL。供材可提前制作 ,减少了自体取材造成的再损伤及其相应的并发症 ,该技术取材方便 ,手术方法简单 ,无需内固定物

Reconstruction of Anterior Crucial Ligament and Medial Crucial Ligament with Allogenic Achilles Tendon under Arthroscopy

Objective To find a new method of reconstruction of anterior crucial ligament (ACL) and medial collateral ligament(MCL) by using allogenic achilles tendon.Methods First hypothermual processed allogenic achilles tendon was used to reconstruct injured ACL under arthroscopy,following the identical length reconstruction and biological fixation methods.Then MCL was resconstructed from a subsidiary incision by utilization of length and strength of achilles tendon.Results From January,1996 to December,2001,we performed 9 cases of ACL and MCL reconstruction with allogenic achilles tendon under arthroscopy.All cases were followed up from 15 to 56 months,with an average of 27 8 months.Among them,Lysholdm score method was used to evaluate the patients.The pre operation score was 43 2,post operation 79 8 and with excellent and good rate of 77 8%.In the objective examination,Anterior drawer test(ADT):9 cases were positive preoperatively,all cases were negative postoperatively; Lachman test:9 cases were positive preoperatively,1 case was weak positive postoperatively; Abductio(valgus) test:9 cases were positive preoperatively,all cases were negative postoperatively.There were 2 cases with pain of knee joints and 3 cases with limitation of activity of knee joints.postoperatively.Conclusion To reconstruction ACL and MCL with allogenic achilles tendon under arthroscopy,we can make supplied materials in advance,decrease the injury and complications caused by the autograft,and reconstructed MCL in the mean times.With this technique,we simplified the operation and no internal fixation.