关节镜结合X线透视双监视法解剖等长重建技术在腘绳肌腱重建前交叉韧带中的应用

目的探讨关节镜结合X线透视双监视法解剖等长重建技术在腘绳肌腱重建前交叉韧带中应用的可行性及近期疗效。方法对30例前交叉韧带损伤行关节镜下ACL重建术。按照建立胫骨、股骨骨道的方法将30例分为双监视组和传统组。每组15例，两组四股半腱肌股薄肌腱股骨端均用Endobutton固定，胫骨端用可吸收界面螺钉固定。结果手术时间：双监视组60-90min，传统组70-90min。术中测量膝关节伸屈0°-90°时移植物位移：双监视组0—2（0．6±0．63）mm，传统组0～2．5（1．27±0．78）mm，两组比较差异有显著性（P〈0．05）。30例均随访6～12个月。根据Lysholm膝关节功能评分：双监视组术前评分：20—60（36．27±9．95）分；术后6个月评分：75～87（81．33±3．66）分（P〈0．01）。传统组术前评分：20～60（38．00±10．56）分；术后6个月评分：74～88（79．27±4．13）分（P〈0．01）。术前与术后两组Lysholm膝关节功能评分比较差异无显著性（P〉0．05）。结论关节镜结合X线透视双监视法解剖等长重建技术应用于腘绳肌腱重建前交叉韧带，术中操作简便，效果可靠。双监视组近期疗效与传统组相似，但术后评分稍高于传统组。

Application of two-stakeout anatomy isometric technique in arthroscopic reconstruction of anterior cruciate ligament with quadruple hamstring tendon autograft

Objective To study the feasibility and short-term effects of anterior cruciate ligament（ACL） two-stakeout anatomy isometric technique in arthroscopic reconstruction with quadruple hamstring tendon autograft. Methods Arthroscopic ACL reconstruction was carried out in 30 patients with ACL injuries by using the quadruple hamstring tendon autograft. 30 patients were randomly divided into two-stakeout anatomy isometric technique group （two-stakeout technique group） and conventional method group according to prepared method of the bone tunnels of the femur and the tibia. Each group included 30 patients. Quadruple hamstring tendon were fixed with endobutton plate. Results The operation time were 60 - 90 min in two-stakeout technique group and 70 - 90 min in conventional method group. No postoperative complications such as synovitis and ligament rupture and movement restriction occurred. A follow-up check up was made in the 30 patients for 6 - 12 months. The transplant isometric point displacement in operation were 0 -2（0.6±0.63） mm from knee joint flexion 90° to extension 0° in two-stakeout technique group and 0 -2.5 （ 1.27 ± 0. 78） mm in conventional method group. There were significant difference in isometric point displacement between two-stakeout technique group and conventional method group. The Lysholm scores improved from a preoperative score of 20 - 60（ 36. 27 ± 9. 95 ） to 75- 87 （81.33 ± 3.66） at follow-up （ P 〈 0. 01 ） in two-stakeout technique group, and from a preoperative score of 20 -60（38.00 ± 10. 56） to 74 -88（79. 27 ±4. 13） at follow-up（P 〈0. 01 ） in conventional method group. There were not significant difference in the Lysholm scores between two-stakeout technique group and conventional method group in 6 months follow-up. But the Lysholm scores in two-stakeout technique group were slightly high than conventional method group. Conclusions Anterior cruciate ligament anatomy isometric technique is simple to perform and gives a satisfactory short-term re