经关节镜中1/3髌韧带重建后交叉韧带

目的 介绍一种关节镜下后交叉韧带(Posterior Cruciate Ligament，简称PCL)重建术并评估其近期临床治疗效果。方法 中1／3骨—髌韧带—骨组织(Bone—Patellar Tendon—Bone Graft，简称BPB)移植重建膝关节后交又韧带，用于治疗后交叉韧带损伤后关节不稳定。手术在关节镜下经前方进路完成。结果 18例患者平均随访13．1个月。Larson评分由术前61分提高到93分。Lysholm评分由术前55分提高到91分。所有患膝术前后抽屉试验及Lachman试验均阳性，术后仅2例抽屉试验弱阳性，1例Lachman弱阳性。所有患者主观评价膝关节功能明显增进，对治疗效果满意。结论 在关节镜直视下，能准确定位后交叉韧带解剖止点，钻制骨遂道，植入移植组织。该技术具有不切开关节囊，损伤小、关节粘连率低的优点。

Arthroscopic reconstruction of posterior cruciate ligament using middle one third of patellar tendon graft

Objective:To introduce an arthroscopic posterior cruciate ligament reconstruction method, and evaluate the earlier clinical results. Methods:To treat unstable knee after posterior cruciate ligament injury by transplantation of middle third of bone-patellar tendon-bone graft(BPB). The operation was performed under arthroscope by anterior approach.Results:Eighteen cases of patients got average follow-up of 13.1 months. The Larson score rise from 61 point to 93 point. The Lysholm score rise from 55 point to 91 point. All patients had positive posterior drawer test and positive Lachman test preoperatively, only 2 cases had slight positive posterior drawer test and 1 case had slight positive Lachman test in the last follow-up time. In the subjective evaluation, all patients considered that their knee's function is greatly improved and were satisfied with the results.Conclusions:Under arthroscope, one can accuratelly localize the anatomic PCL insertion, drill holes and transplant tissue grafts. As no capsule incision,arthroscopic posterior cruciate ligament reconstruction has the advantages of less trauma and lower adherence incidence.