关节镜下应用改良定位器保留残端重建前交叉韧带

目的探讨前交叉韧带（anterior cruciate ligament，ACL）关节镜下应用四股胭绳肌保留残端进行重建的手术治疗方法并观察其效果。方法设计不受前交叉韧带残端干扰，安全准确的定位器。关节镜下不切除原ACL残端，采用自体四股胭绳肌腱，单束重建51例患者（51膝）前交叉韧带损伤的患者。术后随访5～19个月，平均（8．1±2．2）个月，采用Lysholm膝关节功能评分表评估患膝功能。结果术后无膝关节感染发生；术后均无伸膝受限，屈膝活动度100°-135°，平均123°。患者术前Lysholm膝关节功能评分平均为i62．3±6．5）分，终末随访时为（92．3±5．1）分，差异有统计意义（P〈0．05）。结论应用改良定位器，可以关节镜下保留残端，采用自体四股胭绳肌腱重建前交叉韧带。是治疗前交叉韧带损伤的一种微创、安全、有效的手术方法。可能有利于重建韧带血供和神经支配的重新获得，近期疗效佳。

Arthroscopic anterior cruciate ligament reconstruction with the remnant preserving technique using improved locator

Objective To explore the treatment method and clinical effect of arthroscopic anterior cruciate ligament reconstruction with the remnant preserving technique using the quadrup hamstring graft. Methods The safe accurate loeator without interference from the remnant of ACL is designed. 51 knees with ACL tear in 51 eases were reconstructed with single bundle of autogenous quadrup hamstring graft under arthroseqpy without remove of the remnants of ACL. The patients were followed up for 5 to 19 months with an average of 8.1 ± 2.2 months. The IKDC and Lysholm knee score scale were used for functional evaluation. Results No knee infection occurred. There was no limitation of knee extension. Knee flexion was between 100° - 135° with an average of 123°. The Lysholm score of the cases was 62. 3 ±6. 5 before operation,and 92. 3 ±5.1 at the last follow up. Statistically, the difference between the two Lysholm scores is significant （ P 〈 0.05 ）. Conclusion Through using improved loeator, arthroscopic ACL reconstruction with the remnant preserving technique using the quadrup hamstring grafts is possible. It is a kind of minimal invasive safe and effective method to treat ACL tear. It has potential facility to revasculization and reinnervation of the reeonstracted ligament. There is a good clinical effect in near term.