关节镜下自体腘绳肌腱重建膝关节前交叉韧带

目的：探讨关节镜下自体4股腘绳肌腱、生物可吸收挤压螺钉固定重建前交叉韧带（ACL）的临床效果。方法：31例经关节镜检查证实为前交叉韧带断裂的患者，男27例，女4例；年龄17～40岁，平均25岁。其中合并半月板损伤26例，合并局部软骨损伤3例，软骨Ⅰ～Ⅱ度退变16例。均于关节镜下行自体4股腘绳肌腱和软组织生物可吸收挤压固定螺钉重建ACL。术后对膝关节功能进行评定。结果：31例术后均未发生关节感染、血管神经损伤等严重并发症。30例获得随访，时间9-39个月，平均（19±9．0）个月，Lysholm膝关节功能评分从术前平均（54．6±16．6）分提高至随访时平均（92．5±5．7）分，较术前显著改善（t=11．84，P〈0．01）。30例患者中，26例恢复伤前运动水平，2例运动水平较伤前降低，2例因运动后出现关节酸痛而不敢剧烈运动。结论：关节镜下采用4股腘绳肌腱作移植物，生物可吸收挤压螺钉固定，是重建ACL的一种安全可靠的治疗方法。具有手术创伤少、术后膝关节功能恢复良好的优点。

Reconstruction of anterior cruciate ligament with hamstring tendon autografts under arthroscopy

Objective ：To evaluate therapeutic effects for reconstruction of anterior cruciate ligament （ACL）with hamstring tendon autografts and bioabsorbable interference screws fixation under arthroscopy. Methods：Thirty-one patients with ACL rupture were verified through arthroscopy. There were 27 patients were male and 4 patients were female, ranging in age from 17 to 40 years,with an average of 25 years. Among the patients,26 patients combined with meniscus injuries,3 patients with injuries of articular cartilage and 16 patients with Ⅰ to Ⅱ degree degeneration of articular cartilage. All the patients were performed ACL reconstruction with hamstring tendon autografts under arthroscopy and the reconstructed ligaments were fixed with bioabsorbable interference screws. Results：No severe complications occurred at early stage after operation. Thirty patients were followed up and ranged from 9 to 39 months,with an average of （19±9.0）months. Lysholm score significantly increased from average of 54.6±16.6 preoperatively to average of 92.5±5.7 at the end of follow-up period （t=11.84, P〈0.01 ）. Twenty-six patients restored to normal activity. Conclusion：ACL reconstructed with hamstring tendon autografts under arthroscopy has advantages of minimal trauma and satisfactory outcomes.