关节镜下一期自体腘绳肌腱重建前交叉韧带联合LARS韧带重建后交叉韧带

目的探讨关节镜下一期应用自体腘绳肌腱重建前交叉韧带联合LARS人工韧带重建后交叉韧带的临床疗效。方法自2009-02—2010-06对14例膝关节前、后交叉韧带断裂及严重膝关节脱位患者在关节镜下一期采用自体腘绳肌腱重建前交叉韧带联合LARS人工韧带重建后交叉韧带,同时处理合并的侧副韧带及半月板损伤。末次随访时采用膝关节Lysholm评分、IKDC评分评定疗效。结果术后14例均获随访23~36个月,平均29.5个月。均无膝关节肿痛症状、感染、伸膝障碍发生。末次随访时,膝关节屈曲达120°~130°;膝关节IKDC评分：A类11例（78.6%）,B类2例（14.3%）,C类1例（7.1%）;膝关节Lysholm评分（89.2±4.6）分,较术前（54.7±5.3）分明显提高,差异有统计学意义（t=32.156,P=8.91E-14）。结论关节镜下一期应用自体腘绳肌腱重建前交叉韧带联合LARS人工韧带重建后交叉韧带治疗膝关节多韧带损伤临床疗效满意。

One-stage arthroscopic reconstruction of ACL with hamstring tendons and reconstruction of PCL with LARS artificial ligament

Objective To research the therapeutic effect of reconstruction of ACL with hamstring tendons and reconstruction of PCL with LARS artificial ligament. Methods Fourteen patients were accepted reconstruction of ACL with hamstring tendons and reconstruction of PCL with LAIRS artificial ligament for treatment of ACL combined PCL tears or injured with knee dislocation from Feb. 2009 to Jun. 2010, if combined, collateral ligaments injury or meniscus were treated at one time. At last fonow-up, the patients were evaluated according to Lysholm knee scores and IKDC scores. Results All the patients were followed up for 23 to 36 months （average 29.5 months）, no knee pain or limitation of knee extension occurred. At last follow-up, the knee flexion was 120 to 130 degree. According to IKDC scores at the terminal of followed up, 11 cases（78.6%） were graded as A, 2 cases （14.3%） were graded as B and 1 case （7.1%） was graded as C. The average Lysholm scores from （54.7±5.3）points before operation improved to （89.2±4.6）points, there was significant difference（t =32.156,P =8.91E-14）. Conclusion One-stage arthroscopic reconstruction of ACL with hamstring tendons and reconstruction of PCL with tARS artificial ligament to treat multiple knee ligaments injured is an effective method, with good mid-term outcome.