生物可吸收挤压螺钉在膝关节韧带重建术中的应用

目的探讨生物可吸收挤压螺钉在膝关节韧带重建术中的应用和疗效。方法2002年4月~2004年8月,收治膝关节韧带损伤患者39例,其中男33例,女6例;年龄15~65岁,中位年龄25岁。单纯前交叉韧带(anterior cruciate ligament,ACL)损伤29膝,单纯后交叉韧带(posterior cruciate ligament,PCL)损伤6膝,ACL和PCL联合损伤4膝。合并内侧或外侧侧副韧带损伤3膝,合并后外侧结构损伤1膝。病程1周~8年。所有患者均行关节镜下或结合开放韧带重建术,采用自体移植物及生物可吸收螺钉固定。采用Lysholm临床评分系统对膝关节功能进行评估。结果术后34例获随访6~28个月,平均13.7个月。术后膝关节功能评分由术前43.6±13.4分,增加至术后85.4±16.3分,且差异有统计学意义(P<0.05)。患者疼痛均消失,关节稳定,无交锁和无力等症状,均恢复关节活动度,螺钉无松动。术后1例出现感染征象,3例发生局部积液和滑膜炎,经保守治疗后好转。结论在膝关节韧带重建术中,生物可吸收挤压螺钉固定疗效可靠,能有效重建韧带,恢复膝关节稳定性。

BIOABSORBABLE INTERFERENCE SCREW FOR LIGAMENT RECONSTRUCTIONS IN THE KNEE

OBJECTIVE: To evaluate the clinical results of bioabsorbable interference screw in knee ligament reconstruction. METHODS: From April 2002 to August 2004, 39 patients with knee ligament injury were treated, including 33 males and 6 females with a median age of 25 years (15 to 65 years). The involved ligament included 29 anterior cruciate ligament of knee (ACL), 6 posterior cruciate ligament of knee (PCL), 4 combined ACL and PCL, 3 medial collateral or lateral collateral ligaments of knee point and 1 posterolateral complex injury of knee. All of patients underwent anatomic ligament reconstructions under arthroscopy or open surgery by autografts and fixation with bioabsorbable interference screw. RESULTS: All 34 patients were followed up 6 to 28 months (mean 13.7 months). The patients were evaluated by Lysholm knee functional scales, the knee scores were 43.6 +/- 13.4 before operation and 85.4 +/- 16.3 after operation, showing significant difference (P < 0.05). There was no limitation of range of motion and loosening of the screw. However, one case suffered from infection, and 3 cases suffered from effusion and synovitis after surgery and recovered after management. CONCLUSION: Bioabsorbable interference screw fixation is a reliable method in knee ligament reconstruction and is effective to restore knee joint stability.