关节镜下自体六股带骨膜腘绳肌腱四重固定重建前交叉韧带的中期疗效评价

目的:观察关节镜下用自体6股带骨膜腘绳肌腱4重固定重建前交叉韧带(ACL)的临床疗效.方法:选择我院2005年9月至2010年8月单侧膝关节单纯ACL损伤病例共26例,均行自体带骨膜6股腘绳肌腱重建ACL.股骨侧采用微型钢板固定结合挤压固定,胫骨侧用挤压钉固定并用桩钉固定.用Lachman试验、轴移试验、Lysholm评分标准及影像学检查评价疗效.结果:23例获得随访,随访时间12～48个月,平均29个月.Lachman试验及轴移试验:术前所有患者均阳性,术后阴性21例,阳性1例;Lysholm评分从术前(46.12±2.29)分提高到随访时的(97.3±1.7)分,差异有统计学意义(P＜0.05).结论:关节镜下自体带骨膜6股腘绳肌腱4重固定重建ACL能够明显提高膝关节稳定性,中期疗效满意.

Anterior cruciate ligament reconstruction with six stranded autologous periosteum-enveloping Hamstring graft under arthroscope: clinical research

Objective: To explore the therapeutic efficacy of the surgical technique in arthroscopic reconstruction of ACL with six-stranded autologous periosteum-enveloping Hamstring tendons.Methods: Twenty-six cases of simple ACL ruptures were reconstructed arthroscopically with six-stranded Hamstring tendons from September 2005 to August 2010.The grafts were fixed to the femoral with interfacial pressing screws and suspensory plate.The periosteum-enveloped portion of the graft were fixed to the tibia with interfacial pressing screws and pilling screws.The clinical results were evaluated by Lachman test,Pivot shift test and Lysholm rating scales.Results: Twenty-three patients were followed up for 12 to 48 months(mean,29 months).In the preoperative cases,Lachman test and Pivot shift test were positive,and after the surgery,21 Lachman test and Pivot shift test of the cases were negative and 1 case was positive.The average Lysholm score increased from(46.12±2.29) to(97.3±1.7)(P<0.05) after the surgery.Conclusion: Arthroscopic reconstruction of ACL with six-stranded Hamstring tendons is a reliable procedure to restore the stability of the knee.The mid-term outcomes are excellent.