连髌股四头肌腱重建膝前交叉韧带

目的探讨连带髌骨的自体股四头肌腱重建前交叉韧带（anterior crueiate ligament，ACL）的疗效。方法采用连带髌骨的自体股四头肌腱重建ACL18例，男12例，女6例。年龄21～43岁，平均27岁。左10例，右8例。交通事故伤12例，运动伤3例，膝关节扭伤3例。取股四头肌腱保留远端与髌骨相连长15～18cm，直径8—10mm，肌腱断端编织缝合。用骨钻成型股骨端及胫骨端隧道，将肌腱从股骨外髁隧道口牵人胫骨隧道外口，屈膝40°位拉紧肌腱，并将肌腱于两骨隧道外口处缝合于相邻韧带，术后支具制动。结果术后随访平均6个月，采用Lysholm膝关节功能评分，术前平均63．5分，终末随访平均94．5分，提高31分。膝关节稳定，屈伸功能及活动度正常。结论连髌股四头肌腱移植重建十字交叉韧带，方法简单，固定可靠，治疗效果满意。

Anterior cruciate ligament reconstruction with quadriceps tendons connected to patella

Objective To discuss the method and curative effect of anterior cruciate ligament reconstruction with quadriceps tendons connected to patella. Methods Eighteen cases of anterior cruciate ligament reconstructed with quadriceps tendons connected to patella. In this group male 12 and female 6, left side 10 and right 8, the age from 21 to 43 averaged 27 years old, traffic accident 12 cases, sport injure 3 cases and sprained knee in 3. Quadriceps tendons and patella were connected by the up side of patella,the length of quadriceps tendons 15 - 18 cm, the diameter was 8 - 10 mm, the edge and end of tendons to weave suture. The tunnel were prepared by born drill. Pulling the tendon into the tunnel of the femoral side, through the joint,pulling the tendons into the tunnel of tibia side. The weaving suture of tendons were passing underneath of bone bridge of tibia side tie together and to fix the knee joint at 40° in flexion. Results The patients were followed up average for 6 months. The Lysholm scores improved from a preoperative average score of 63.5 to 94. 5 at follow - up. there were no knee extension limited, the function and stable of walking and activities had apparent improvement,each patient was evaluated using Lysholm knee functional scales, there were no poor results. Conclusion Anterior cruciate ligament reconstruction with quadriceps tendons connected to patella is a reliable method. The advantages are biology fixation, benefit for healing tendons and simple to perform.