关节镜下自体骨-髌韧带-骨重建前交叉韧带效果评价

目的　评价关节镜下用自体1/3髌骨-髌韧带-骨重建前交叉韧带的技术和疗效。 方法　自2003年1月至2010年1月对35例前交叉韧带断裂患者行关节镜下自体髌骨-髌韧带-骨重建前交叉韧带术，其中男22例，女13例，年龄23.0岁（20.0 -28.0岁），左膝关节18例，右膝17例。35例患者均为急性损伤，受伤前均为体育运动爱好者。 结果　随访1-6年，平均3.0年，采用lysholm评分标准评价膝关节功能，术前平均59.40分（45-81分），术后平均91.80分（72-100分），术后与术前相比有显著差异性（p<0.5）。35例患者术后均无前叉韧带再断裂，术后34例恢复受伤前运动水平，1例运动水平较受伤前降低。术后1年有2例患者在膝极度屈曲位时有轻微膝前疼痛，但对运动水平无显著影响。 结论　关节镜下自体髌骨-髌韧带-骨重建前交叉韧带是一种微创有效的手术方法，尤其对年轻、活动量大、要求早期恢复高强度运动的患者是一种较佳的选择。

Recoonstruction of anterior cruciate ligament with autogenous bone-patellar eendon-bone under knee arthroscopy

Objective　To evaluate the technique and outcome of arthroscopic anterior cruciate ligament(ACL) re-construction with autogenous bone-patellar tendon-bone.　Methods　From Jan. 2003 to Jan. 2010, 35 knees with ACL tear in 35 patients were verified with arthroscopy in this department. Of them, there were 22 males and 13 females, and the average age was 23.0 years (ranged from 20.0~28.0 years). The lesions were left knees in 18 and right knees in 17, and all were acute injuries and all the damaged ACLs were reconstructed with autogenous bone-patellar tendon-bone under knee arthroscopy. All patients were keen participants in sports.　Results　All patients were followed up for 1 to 6 years with an average of 3.0 years. The patients were evaluated according to the Lysholm knee scoring scale.The score was remarkable improvement from 45~81 points (mean 59.40 points) preoperatively to 72~100 points ( mean 91.80 points) at follow up (P<0.0001). Of the 35 patients, 34 patients returned to the same preinjury sports level and only 1 was below the preinjury sports level. There was no patellar fracture and loosing of the screws. Only one patient feel little pain in knee.　Conclusions　The autogenous bone-patellar tendon-bone with advantage of minimal trauma in surgery, reliable satisfactory outcome especially good for the youth who are keen participants in sports.