单隧道双束膨胀界面钉固定重建前交叉韧带的初步临床研究

目的探讨关节镜下单隧道双束膨胀界面钉重建前交叉韧带（anteriorcruciateligament，ACL）的早期疗效。方法对40例ACL损伤患者行关节镜下单隧道前内侧束与后外侧束双束异体胫前肌ACL解剖重建，股骨隧道采用自行研制的膨胀界面钉固定法，胫骨隧道采用界面螺钉束间固定法，屈膝60。拉紧固定。结果40例获得随访6－30个月，平均25．2个月。术前麦氏征阳性6例，抽屉试验阳性21例，Lachman试验40例均阳性；术后上述3项试验结果均为阴性。IKDC（IntemationalKneeDocumentationCommittee）评分术前（D级28例，C级12例）与术后末次随访（A级34例，B级6例）相比较，差异具有统计学意义（P〈0．05）；比较手术前后Lysholm膝关节功能评分（6l-3士7-2）VS（91．64-4．3）]，差异具有统计学意义（P〈0．05）。结论关节镜下单隧道双束膨胀界面钉固定重建ACL能够恢复原有ACL的解剖学特点及生物力学特性，操作简单，近期疗效满意。

Preliminary study on anterior cruciate ligament reconstruction using single-tunnel double-bundle methods with expandable interference screw fixation

Objective To investigate the preliminary results of anterior cruciate ligament （ACL） reconstruction through singletunnel doublebundle methods with expandable interference screw fixation. Methods Forty patients with ACL injury underwent arthroscopic ACL reconstruction by double bundles （anteromedial and posterolateral bundles） of anterior tibialis tendon allografts with the fixation of expandable interference screw （designed by ourselves） in the femoral ttmnel and interface screw between two bundles in the tibial tunnel at the knee held in 600 Of flexion. Results All patients were followed up at an average of 25.2 months （range of 6 to 30 months）. The preoperative McMurray test was positive in 6 cases, anterior drawer test positive in 21 cases, and Eachman test positive in all cases Postoperative results showed all of those tests negative. IDKC （International Knee Documentation Committee） scores at the latest followup （A grade of 34 cases, B grade of 6 cases） improved when compared with preoperative ones （D grade of 28 cases, C grade of 12 cases）, and there was statistical difference of Lysholm score between preoperation and postoperation （61.3 〈 7.2） vs （91.6〈 4.3）, P 〈0.05]. Conclusion ACL reconstruction using singletunnel doublebundle method with expandable interference screw fixation is easy to operate and satisfied in the shortterm effect, which is helpful to restore the original anatomical and biomechanical characteristics.