六股自体腘绳肌腱“人”字形编织重建膝关节前交叉韧带

背景：目前不同学者对膝关节损伤前交叉韧带重建方法存较多争论,因此寻找简便、经济的修复方法是目前该领域的研究热点。目的：观察关节镜下应用6股自体腘绳肌腱＂人＂字形编织重建修复前交叉韧带损伤的临床疗效。方法：对19例单侧前交叉韧带功能不全的患者采用6股自体腘绳肌腱人字形编织,胫骨隧道钻取双隧道模拟前内、后外两束重建膝关节前交叉韧带,于重建前后利用IKDC分级,Lysholm功能评分和KT-2000^TM关节动度仪测试试验,对患者进行主观和客观评分,并应用IKDC分级进行影像学评估。结果：19例患者随访的IKDC分级：A级8例、B级10例、C级1例,无伸膝受限,活动范围120°～140°,平均126°。KT-2000TM膝关节稳定性测量在90.7kg,136.1kg和最大拉力时,患膝和健膝之间的关节活动度差异均无显著性意义（P〉0.05）。随访时Lysholm膝关节功能评分显著高于重建前（P〈0.01）。影像学IKDC评估为：A级15例（79%）,B级3例（16%）,C级1例（5%）。结果证实,应用6股自体腘绳肌腱＂人＂字形编织双束重建前交叉韧带短期临床疗效良好。

Clinical effect of anterior cruciate ligament reconstruction using six-strand hamstring grafts under a knee arthroscopy

BACKGROUND：At present,there are a lot of controversial exists in the methods of anterior cruciate ligament reconstruction by different scholars.Looking for simple and economical repair methods is the research focus.OBJECTIVE：To explore the clinical effect of arthroscopic anterior cruciate ligament（ACL） reconstruction with six-strand hamstring tendon autografts.METHODS：Nineteen non-consecutive randomized patients with unilateral ACL insufficiency received six-strand hamstring tendon autografts reconstruction by using double tibia tunnel technique.Patients were evaluated subjectively and objectively before and after ACL reconstruction,using IKDC score,Lysholm score system,manual maximum displacement test with KT-2000TM arthrometer.Radiographic evaluation was performed according to IKDC grading system.RESULTS AND CONCLUSION：The subjective and objective IKDC were 8 in A（42.1%）,10 in B（52.6%） and only 1 C（5.4%）and radiographic IKDC were 15 in A（78.9%）,3 in B（15.7%）,1 in C（5.4%）.Passive range of motion recovery was within 120°-140°（average 126°）.The measured data by KT-2000^TM in normal and operated knee were 6.1±0.2 and 6.5±0.8,6.3±0.5 and 7.1±0.9,7.2±0.6 and 8.3±1.2,at the tensile fore of 20 pound,30 pound and the largest,respectively.Lysholm score were 51.8±8.6 before operation and 86.5±12.3 at the last followed-up.The double bundle of ACL reconstruction by hamstring tendon autograft shows satisfactory functional results in the early period.