关节镜下单束重建治疗前交叉韧带部分断裂的临床研究

目的探讨关节镜下单束重建治疗前叉韧带部分断裂的临床疗效及手术方法。方法回顾性分析2007年6月至2009年10月关节镜下应用单束重建治疗前叉韧带部分断裂12例患者的资料。12例患者中,男9例,女3例,平均年龄37岁。根据IKDC、Lysholm膝关节功能评分进行功能恢复评估。结果 12例患者平均随访13个月,所有患者术后均无感染。术后最后一次随访时Lachman试验（﹢）、前抽屉实验（-）2例,其他患者前抽屉试验、Lachman试验均为阴性。11例膝关节屈伸活动度正常,1例膝关节伸直缺失10°,IKDC评级：11例正常,1例接近正常。术前IKDC主观评分（48.33±12.77）,Lysholm膝关节功能评分（55.42±15.01）;术后末次随访IKDC主观评分（91.42±4.94）,Lysholm膝关节功能评分（95.33±6.02）,差异有统计学意义（P〈0.01）。结论关节镜下单束单隧道重建治疗前叉韧带部分断裂的短期临床疗效满意,保留残存纤维束重建虽然有一定难度,但手术在熟练的关节镜技术下可以顺利施行。

Single-bundle augmentation technique in treatment of partial anterior cruciate ligament injury

Objective To investigate the surgical skills and short term clinical outcomes of arthroscopic single-bundle augmentation technique in treatment of partial cruciate ligament (ACL) injury. Methods From June 2007 to October 2009, 12 patients with partial curciate ligament injury were treated with single bundle reconstruction, preserving the intact ACL bundle as well. 10 cases underwent reconstruction with autologous hamstring ligament, and two cases with allogenic tendon. The International Knee Documentation Committee (IKDC), Lysholm knee score and Lachman test were used to measure the knee function preoperatively and postoperatively. Results The ACL tear involved the anteromedial bundle (AMB) in eight cases, and the posterolateral bundle (PLB) in four cases. The mean IKDC subjective evaluation scores were (48.33±12.77) preoperatively and (91.42±4.94) at the last follow-up (P<0.01). The mean Lysholm knee scores were (55.42±15.01) preoperatively and (95.33±6.02) at the last follow-up (P<0.01). All patients had showed normal range of motion except one patient had 10 degrees extensor lag. Conclusion Single-bundle augmentation technique could improve the joint stability, Lysholm scores and the IKDC subjective evaluation postoperatively. This procedure can be a treatment option for patients whose ACL are left in certain conditions.